Association between the perivascular fat attenuation index and CCTA-defined anatomically significant left anterior descending coronary artery stenosis: relationship with serum inflammatory biomarkers.

Authors

Yiliya Ahongjiang, Alimujiang Abudukaiyoumu, Gulinuer Abulimiti, Hamisiguli Tuerxun, Aibibulajiang Mutailifu

Published in

Frontiers in cardiovascular medicine. Volume 13. Pages 1823667. Epub Oct 19, 2026.

Abstract

To investigate whether lesion-specific perivascular fat attenuation index (FAI) is associated with CCTA-defined anatomically significant (≥50%) left anterior descending coronary artery (LAD) stenosis and to evaluate the diagnostic performance of a composite model integrating serum inflammatory biomarkers.
We retrospectively analyzed 160 patients with suspected coronary artery disease (CAD) who underwent coronary computed tomography angiography (CCTA). Patients receiving anti-inflammatory medications were excluded. Lesion-specific perivascular FAI was measured around the LAD. The prespecified primary outcome was CCTA-defined anatomically significant LAD stenosis (≥50%), analysed as a binary variable. Multivariable logistic regression identified independent predictors, and the final model was internally evaluated with stratified 5-fold cross-validation, 10-fold cross-validation, and 1,000-bootstrap resampling. Model building was repeated within each resample. Calibration (slope, calibration-in-the-large, Brier score) and incremental discrimination (DeLong test) were assessed.
Patients with CCTA-defined anatomically significant stenosis (≥50%) had higher, less negative FAI values, higher hs-CRP and LDH levels, and a lower ApoA1/ApoB ratio than those with stenosis <50% (all P < 0.05). FAI correlated with stenosis both as a continuous percentage (ρ = 0.54, P < 0.001) and as a binary ≥50% variable (ρ = 0.64, P < 0.001), with less negative FAI values accompanying more severe stenosis. The final model identified FAI (OR = 1.055, 95% CI: 1.014-1.098), hs-CRP (OR = 1.063, 95% CI: 1.005-1.125), LDH (OR = 1.014, 95% CI: 1.005-1.023), and the ApoA1/ApoB ratio (OR = 0.209, 95% CI: 0.070-0.624) as independent predictors. The composite model achieved an AUC of 0.915 (95% CI: 0.865-0.965); internal validation yielded AUCs of 0.872 (5-fold), 0.881 (95% CI: 0.826-0.936; 10-fold), and 0.895 (95% CI: 0.848-0.942; bootstrap). On formal DeLong testing for correlated ROC curves, the composite model showed significantly better discrimination than hs-CRP alone (P  =  0.020) and than FAI alone (P < 0.001).
Higher, less negative perivascular FAI values were associated with CCTA-defined anatomically significant LAD stenosis. A composite model integrating FAI, hs-CRP, LDH, and the ApoA1/ApoB ratio showed high apparent diagnostic accuracy and remained stable across multiple internal validation strategies. Because this was a single-centre retrospective study without external validation or outcome data, these findings should be regarded as preliminary and hypothesis-generating; the model is not ready for clinical use.

PMID:
42973467
Bibliographic data and abstract were imported from PubMed on 03 Nov 2026.

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