Evidence map›Paper›PMID 38093240›Full record

ArticleBMC cardiovascular disorders2023

Prognostic value of CT-derived fractional flow reserve and fat attenuation index in patients with suspected coronary artery disease: a sex-disaggregated analyses.

Yang Yu, Jieli Kou, Fuqian Guo, Dan Zhang, Tong Pan, Yicheng Chen, Wenjun Bao, Yuhan Sun, Haowen Zhang, Caiying Li

Open access · goldAbstract read
In one paragraph

Article in BMC cardiovascular disorders, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
1.3field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 6 citations in OpenAlex.

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  6. Association Between Chinese Visceral Adiposity Index and Risk of Incident Hypertension Among Older Adults: A Prospective Cohort Study.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Yang YuDepartment of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China.
Jieli KouDepartment of Medical Imaging, Cangzhou People's Hospital, Cangzhou, China.
Fuqian GuoDepartment of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China.
Dan ZhangDepartment of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China.
Tong PanDepartment of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China.
Yicheng ChenDepartment of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China.
Wenjun BaoDepartment of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China.
Yuhan SunDepartment of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China.
Haowen ZhangDepartment of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China.
Caiying LiDepartment of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China. mscaiyingli@163.com.
Hebei Medical University · CNPeople's Hospital of Cangzhou · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere are sex differences in many risk factors associated with coronary artery disease (CAD). CT-derived fractional flow reserve (CT-FFR) and fat attenuation index (FAI) have been shown to independently predict cardiovascular events. We aimed to examine the impact of sex on the prognostic value of CT-FFR and FAI in suspected CAD patients, and to examine the incremental prognostic value of FAI over CT-FFR in both sex.

methodsA total of 1334 consecutive suspected CAD subjects who underwent coronary computed tomographic angiography (CCTA) were retrospectively collected. We divided the patients into males and females and calculated CT-FFR and FAI data from CCTA images. Kaplan-Meier analysis was used to assess the risk of major adverse cardiovascular events (MACE) stratified by CT-FFR and FAI in both sex. Cox regression models were used to assess the incremental prognostic value of FAI by adding the variable to a model that included CT-FFR and clinical variables.

resultsDuring a median follow-up of 2.08 years, 212 patients had MACE. CT-FFR ≤ 0.80 was significantly associated with MACE in both sex. FAI value of left anterior descending artery (FAI[LAD]) and FAI value of left circumflex (FAI[LCX]) ≥ 70.1 were significantly associated with MACE in females. FAI[LCX] added incremental prognostic value over clinical and CT-FFR variables in females, with hazard ratio (HR) 3.230 (1.982-5.265, P = 0.000), Harrel's C 0.669 (P < 0.001), net reclassification improvement (NRI) 0.161 (0.073-0.260, P < 0.001), and integrated discrimination index (IDI) 0.036 (0.008-0.090, P = 0.010). FAI[LAD] did not enhance risk prediction in females (Harrel's C 0.643, P = 0.054; NRI 0.041, P = 0.189; IDI 0.005, P = 0.259). The decision curve analysis demonstrated that the model including FAI[LCX] resulted in the highest net benefit.

conclusionsIn suspected CAD patients, the prognostic value of CT-FFR is not significantly biased by sex. The prognostic value of FAI[LAD] and FAI[LCX] were significantly associated with MACE in females, but not males. FAI[LCX], not FAI[LAD], added incremental prognostic value over CT-FFR and might enhance CT-FFR risk stratification in females.

Indexed as

Coronary Artery DiseaseCoronary StenosisFractional Flow Reserve, MyocardialComputed Tomography AngiographyCoronary AngiographyFemaleHumansMalePredictive Value of TestsPrognosisRetrospective StudiesTomography, X-Ray ComputedCoronary artery diseaseCT-derived fractional flow reserveFat attenuation indexMajor adverse cardiovascular eventsPrognosis

Identifiers

PMID38093240
PMCPMC10720191
OpenAlexW4389668868

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.