Background:
Postoperative new atrial fibrillation (POAF) is a commonly
observed complication after off-pump coronary artery bypass surgery (OPCABG), and
models based on radiomics features of epicardial adipose tissue (EAT) on
non-enhanced computer tomography (CT) to predict the occurrence of POAF after
OPCABG remains unclear. This study aims to establish and validate models based on
radiomics signature to predict POAF after OPCABG.
Methods:
Clinical
characteristics, radiomics signature and features of non-enhanced CT images of 96
patients who underwent OPCABG were collected. The participants were divided into
a training and a validation cohort randomly, with a ratio of 7:3. Clinical
characteristics and EAT CT features with statistical significance in the
multivariate logistic regression analysis were utilized to build the clinical
model. The least absolute shrinkage and selection operator (LASSO) algorithm was
used to identify significant radiomics features to establish the radiomics model.
The combined model was constructed by integrating the clinical and radiomics
models.
Results:
The area under the curve (AUC) of the clinical model in
the training and validation cohorts were 0.761 (95% CI: 0.634–0.888) and 0.797
(95% CI: 0.587–1.000), respectively. The radiomics model showed better
discrimination ability than the clinical model, with AUC of 0.884 (95% CI:
0.806–0.961) and 0.891 (95% CI: 0.772–1.000) respectively for the training and
the validation cohort. The combined model performed best and exhibited the best
predictive ability among the three models, with AUC of 0.922 (95% CI:
0.853–0.990) in the training cohort and 0.913 (95% CI: 0.798–1.000) in the
validation cohort. The calibration curve demonstrated strong concordance between
the predicted and actual observations in both cohorts. Furthermore, the
Hosmer-Lemeshow test yielded
p
value of 0.241 and 0.277 for the training and
validation cohorts, respectively, indicating satisfactory calibration.
Conclusions:
The superior performance of the combined model suggests
that integrating of clinical characteristics, radiomics signature and features on
non-enhanced CT images of EAT may enhance the accuracy of predicting POAF after
OPCABG.