Effect of pericoronary adipose tissue thickness on the long-term prognosis of STEMI patients after PCI

Objective To investigate the predictive value of pericoronary adipose tissue (PCAT) thickness on the long-term prognosis of patients with ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI). Methods A total of 195 patients who initially suffered from STEMI and underwent PCI at Nanjing Drum Tower Hospital followed by postoperative cardiac magnetic resonance examination from October 2019 to October 2021 were enrolled for retrospective analysis. Their general information, laboratory examination results, and cardiac magnetic resonance indexes were collected. All the patients were followed-up for 12 months after discharge. According to the occurrence of major adverse cardiovascular events (MACE), the patients were divided into two groups: a MACE group and a non-MACE group. Independent risk factors for MACE were determined by logistic regression analysis. ROC curves were plotted to analyze the predictive value of PCAT thickness and other indicators on the occurrence of MACE. Results Compared with the non-MACE group, the MACE group showed statistical differences in age, troponin T and B-type natriuretic peptide (BNP) levels, left ventricular ejection fraction (LVEF), left ventricular infarct area, microvascular occlusion (MVO), and adipose tissue thickness at superior interventricular groove (SIVGi) (P<0.05). According to multivariate logistic regression analysis, after adjustment for other risk factors, increased SIVGi (OR=2.742, 95%CI 1.763-4.266, P<0.001) was still an independent risk factor for the occurrence of postoperative MACE in STEMI patients. Increased LVEF (OR=0.852, 95%CI 0.775-0.935, P=0.001) was a protective factor. The AUC value of SIVGi combined with LVEF in predicting MACE in STEMI patients after PCI was 0.834, with a sensitivity of 0.833 and a specificity of 0.739 (P<0.001). Conclusions SIVGi and LVEF are independent predictors of the occurrence of MACE. Measurement of SIVGi and LVEF by cardiac magnetic resonance in STEMI patients can facilitate intensive interventions for those at high risks of MACE, in order to improve prognosis.