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KMID : 1102220220410010066
Kidney Research and Clinical Practice
2022 Volume.41 No. 1 p.66 ~ p.76
Pericoronary fat attenuation index in computed tomography angiography is associated with mortality in end-stage renal disease
Cho Nam-Jun

Nam Bo-Da
Park Samel
Kim Hyoung-Nae
Noh Hyun-Jin
Jeon Jin-Seok
Han Dong-Cheol
Lee Eun-Young
Gil Hyo-Wook
Kwon Soon-Hyo
Abstract
Background: An increased pericoronary fat attenuation index (FAI) on computed tomography angiography (CTA) is associated with increased all-cause and cardiac mortality in the general population. However, the ability of pericoronary FAI to predict long-term outcomes in chronic kidney disease (CKD) patients is unknown.

Methods: In this single-center retrospective longitudinal cohort study, we assessed the utility of CTA-based pericoronary FAI measurement to predict mortality of CKD patients, including those with end-stage renal disease (ESRD). Mapping and analysis of pericoronary FAI involved three major proximal coronary arteries. The prognostic value of pericoronary FAI for long-term mortality was assessed with multivariable Cox regression models.

Results: Among 268 CKD participants who underwent coronary CTA, 209 participants with left anterior descending artery (LAD) FAI measurements were included. The pericoronary FAI measured at the LAD was not significantly associated with adjusted risk of all-cause mortality (hazard ratio [HR], 2.08; 95% confidence interval [CI], 0.94-3.51) in any CKD group. However, ESRD patients with elevated pericoronary FAI values had a greater adjusted risk of all-cause mortality compared with the low-FAI group (HR, 2.26; 95% CI, 1.11-4.61).

Conclusion: The pericoronary FAI measured at the LAD predicted long-term mortality in patients with ESRD, which could provide an opportunity for early primary intervention in ESRD patients.
KEYWORD
Chronic kidney disease, Coronary inflammation, End-stage renal disease, Mortality
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