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Outline
To explore the predictive value of fat attenuation index （FAI） and fibrous plaque index （FPI） for the prognosis of patients with acute coronary syndrome （ACS）.
A retrospective cohort study was conducted on 334 ACS patients undergoing percutaneous coronary intervention （PCI） in the First Affiliated Hospital of Army Military Medical University and Yongchuan Hospital of Chongqing Medical University from March 2021 to July 2023. All patients received coronary computed tomography angiography （CCTA） to measure FAI and FPI. According to the occurrence of major adverse cardiovascular events （MACE） with 1 year of follow-up，they were divided into MACE group （n=108） and non-MACE group （n=226）. The baseline data，CCTA data and results of laboratory tests were collected and compared between the 2 groups. Multivariate logistic regression analysis was used to analyze the relationship of FAI and FPI with the prognosis of ACS patients，and ROC curve was drawn to evaluate its predictive efficiency.
Among the 334 ACS patients，108 （32.34%） experienced MACE. When compared with the non-MACE group，the MACE group exhibited significantly larger proportions of diabetes （72.22% vs 31.86%） and left main coronary artery disease （18.52% vs 7.08%），but lower success rate of operation （79.63% vs 93.81%，P<0.05）. Radiologic results showed that the proportion of severe stenosis （20.37% vs 10.62%），FAI （-80.12±6.41 HU vs -72.34±7.09 HU） and FPI （0.58±0.41 vs 0.26±0.12） were obviously increased in the MACE group than the non-MACE group （P<0.05）. Laboratory tests indicated that there were statistical differences between the 2 groups in high-density lipoprotein-cholesterol （HDL-C，1.20±0.15 vs 1.09±0.16 mmol/L），miR-126 （0.91±0.12 vs 0.96±0.15） and SST2 （38.45±5.67 vs 34.30±4.89 ng/mL，P<0.05）. Multivariate Logistic regression analysis revealed that FAI （OR=1.200，95%CI：1.136~1.268），FPI （OR=63.157，95%CI：14.126~282.374），moderate stenosis （OR=1.332，95%CI：1.024~1.859），severe stenosis （OR=1.480，95%CI：1.074~2.039），miR-126 （OR=0.007，95%CI：0.001~0.077），and sST2 （OR=1.192，95%CI：1.113~1.277） were independent predictors of MACE （P<0.05）. ROC curve analysis displayed that stenosis degree （AUC=0.622，95%CI：0.561~0.683，P=0.001），FAI （AUC=0.790，95%CI：0.741~0.839，P=0.001） and FPI （AUC=0.700，95%CI：0.638~0.761，P=0.001），miR-126（AUC=0.646，95%CI：0.584~0.707，P=0.001），sST2 （AUC=0.700，95%CI：0.638~0.761，P=0.001） had certain predictive values for ACS prognosis.
Coronary FAI and FPI can be used as independent prognostic indicators of ACS patients，and their numerical changes are closely related to plaque stability and inflammatory state.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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