The role of pericoronary fat thickness in prediction of long-term outcomes after percutaneous coronary intervention for chronic total occlusions.

Introduction: Pericoronary fat thickness (PFT) is a well-established marker crucial for evaluating the extent and severity of coronary artery disease (CAD). While its role in CAD is widely acknowledged, a considerable gap exists in understanding the prognostic implications of PFT after percutaneous coronary intervention (PCI), specifically for coronary chronic total occlusions (CTO).

Aim: This study investigated the relationship between PFT and prognostic outcomes in patients undergoing PCI for CTO.

Material and methods: A retrospective study analyzed data from 415 patients who had undergone coronary computed tomography angiography (CCTA) and coronary angiography (CAG). PFT measurements were taken, and patients were categorized into normal, PCI (non-CTO), and CTO-PCI groups. Prognostic implications within the CTO-PCI group were evaluated based on survival status.

Results: PFT measurements varied significantly among groups. The CTO-PCI group had a 13.9% mortality rate over a median follow-up of 16.6 ±10.3 months. Higher average PFT values were found in the non-survival group (p = 0.013). ROC curve analysis identified an average PFT cut-off value of 13.6 mm (AUC = 0.682, p = 0.011). Cox regression analysis linked mortality with LVEF (HR = 0.938, p = 0.001), albumin (HR = 0.189, p = 0.006), and average PFT (HR = 1.252, p = 0.040). Elevated average PFT was associated with higher mortality (p = 0.001).

Conclusions: PFT is a significant inflammatory marker and a promising prognostic indicator following PCI for CTO. Integrating PFT into risk prediction models may enhance prognostic accuracy and aid in timely clinical interventions.