CT-derived fractional flow reserve combined with atherosclero-tic extent to determine long-term outcomes in diabetic pati-ents with coronary artery disease
Zhi-Qiang WANG
Zhen-Nan LI
Zhi-Hui HOU
Bin LU
Department of Radiology,Fuwai Hospital,State Key laboratory of Cardiovascular Disease,National Center for Cardi-ovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China
摘要：Background There is still limited data on predictive value of coronary computed tomography angiography(CCTA)-derived fractional flow reserve(CT-FFR)for long term outcomes.We examined the long-term prognostic value of CT-FFR combined with CCTA-defined atherosclerotic extent in diabetic patients with coronary artery disease(CAD).
Methods A retrospective pooled analysis of individual patient data was performed.Deep-learning-based vessel-specific CT-FFR was calculated.All patients enrolled were followed-up for at least 5 years.Predictive abilities for major adverse cardiac events(MACE)were compared among three models(model 1,constructed using clinical variables;model 2,model 1+CCTA-de-rived atherosclerotic extent(Leiden risk score);and model 3,model 2+CT-FFR.
Results A total of 480 diabetic patients[median age,61(55-66)years;52.9%men]were included.During a median follow-up time of 2197(2126-2355)days,55 patients(11.5%)experienced MACE.In multivariate-adjusted Cox models,Leiden risk score(HR:1.06;95%CI:1.01-1.11;P=0.013)and CT-FFR≤0.80(HR:6.54;95%CI:3.18-13.45;P<0.001)were the independent predict-ors.The discriminant ability was higher in model 2 than in model 1(C-index,0.75 vs.0.63;P<0.001)and was further promoted by adding CT-FFR to model 3(C-index,0.81 vs.0.75;P=0.002).Net reclassification improvement(NRI)was 0.19(P=0.009)for model 2 beyond model 1.Of note,adding CT-FFR to model 3 also exhibited significantly improved reclassification compared with model 2(NRI=0.14;P=0.011).
Conclusion In diabetic patients with CAD,CT-FFR provides robust and incremental prognostic information for predicting long-term outcomes.The combined model exhibits improved prediction abilities,which is beneficial for risk stratification.
机标关键词：fractionalwithflowarteryatherosclerocombinedcoronaryct-derived
论文发表日期：2026-01-30
在线出版日期：2026-03-16（本平台首次上网日期，不代表文献的发表时间）
页数：9( 27-35 )