Correlation Between Fat Attenuation Index and Major Adverse Cardiovascular Events: A Systematic Review and Meta-Analysis

Abstract Background The clinical predictive value of fat attenuation index (FAI) to major adverse cardiovascular events(MACE) remains uncertain. Objectives This study aimed to determine the relationship between FAI on coronary computed tomography angiography and MACE. Methods We searched four databases for cohort studies, case-control studies and cross- sectional studies on the relationship between FAI and MACE.We used RevMan5.4 for heterogeneity testing and statistical pooling. MACE was defined as the outcome measure, and publication bias was assessed using a funnel plot. Results 22 studies involving 10224 participants were enrolled. The results suggested that a significant correlation between adverse cardiovascular events and total FAI(FAI as a categorical variable: HR = 2.77, 95% CI = [2.22, 3.46], P < 0.00001, FAI as a continuous variable: HR = 1.15, 95% CI = [1.05, 1.26], P = 0.003), FAI of right coronary artery(RCA)branch(FAI as a categorical variable: HR = 2.10, 95% CI = [1.58, 2.79], P < 0.00001, FAI as a continuous variable: HR =1.06, 95% CI = [1.04, 1.08], P < 0.00001), FAI of left anterior descending (LAD) branch(FAI as a categorical variable: HR= 2.76, 95% CI= [1.93, 3.97], P < 0.00001, FAI as a continuous variable: HR= 1.09, 95% CI= [1.01,1.16], P < 0.00001), FAI of left circumflex coronary artery (LCX) branch(FAI as a categorical variable: HR=2.68, 95% CI=[1.24, 5.80], P=0.01, FAI as a continuous variable: HR=1.07, 95% CI = [1.05, 1.10], P < 0.00001),with individuals with elevated FAI levels having a significantly increased risk of developing adverse cardiovascular events. The funnel plot showed no publication bias. Conclusion As FAI levels increase, the risk of adverse cardiovascular events increases significantly. FAI may be a promising imaging indicator to predict MACE. (Correlation between fat attenuation index and major adverse cardiovascular events;CRD42022346488)