Abstract
Background
Inflammation surrounding the coronary arteries can be non-invasively assessed using
pericoronary adipose tissue attenuation (PCAT). While PCAT holds promise for further
risk stratification of patients with low coronary artery disease (CAD) prevalence,
its value in higher risk populations remains unknown.
Methods
CORE320 enrolled patients referred for invasive coronary angiography with known or
suspected CAD. Coronary computed tomography angiography (CCTA) images were collected
for 381 patients for whom clinical outcomes were assessed 5 years after enrollment.
Using semi-automated image analysis software, PCAT was obtained and normalized for
the right coronary (RCA), left anterior descending (LAD), and left circumflex arteries
(LCx). The association between PCAT and major adverse cardiovascular events (MACE)
during follow up was assessed using Cox regression models.
Results
Thirty-seven patients were excluded due to technical failure. For the remaining 344
patients, median age was 62 (interquartile range, 55–68) with 59% having ≥1 coronary
artery stenosis of ≥50% by quantitative coronary angiography. Mean attenuation values
for PCAT in RCA, LAD, and LCx were −74.9, −74.2, and −71.2, respectively. Hazard ratios
and 95% confidence intervals (CI) for normalized PCAT in the RCA, LAD, and LCx for
MACE were 0.96 (CI: 0.75–1.22, p = 0.71), 1.31 (95% CI: 0.96–1.78, p = 0.09),
and 0.98 (95% CI: 0.78–1.22, p = 0.84), respectively. For death, stroke, or myocardial
infarction only, hazard ratios were 0.68 (0.44–1.07), 0.85 (0.56–1.29), and 0.57 (0.41–0.80),
respectively.
Conclusions
In patients referred for invasive coronary angiography with suspected CAD, PCAT did
not predict MACE during long term follow up. Further studies are needed to understand
the relationship of PCAT with CAD risk.
Keywords
Abbreviations:
AUC (area under receiver operator characteristics curve), CABG (coronary artery bypass grafting), CAD (coronary artery disease), CCTA (coronary computed tomography angiogram), CI (confidence interval), HR (hazard ratio), HU (Hounsfield units), ICA (invasive coronary angiography), LAD (left anterior descending artery), LCx (left circumflex artery), MACE (major adverse cardiovascular events), MI (myocardial infarction), PCI (percutaneous coronary intervention), PCAT (pericoronary adipose tissue attenuation), RCA (right coronary artery)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 23, 2022
Accepted:
May 15,
2022
Received in revised form:
May 12,
2022
Received:
December 10,
2021
Identification
Copyright
© 2022 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.
