Pericoronary Adipose Tissue Attenuation Is Associated with High-Risk Plaque and Subsequent Acute Coronary Syndrome in Patients with Stable Coronary Artery Disease

Abstract

Background: High-risk plaques (HRP) detected on coronary computed tomography angiography (CTA) confer an increased risk of acute coronary syndrome (ACS). Pericoronary adipose tissue attenuation (PCAT) is a novel biomarker of coronary inflammation. This study aimed to evaluate the association of PCAT with HRP and subsequent ACS development in patients with stable coronary artery disease (CAD). Methods: Patients with stable CAD who underwent coronary CTA from 2011 to 2016 and had available outcome data were included. We studied 41 patients with HRP propensity matched to 41 controls without HRP (60 ± 10 years, 67% males). PCAT was assessed using semi-automated software on a per-patient basis in the proximal right coronary artery (PCATRCA) and a per-lesion basis (PCATLesion) around HRP in cases and the highest-grade stenosis lesions in controls. Results: PCATRCA and PCATLesion were higher in HRP patients than controls (PCATRCA: −80.7 ± 6.50 HU vs. −84.2 ± 8.09 HU, p = 0.03; PCATLesion: −79.6 ± 7.86 HU vs. −84.2 ± 10.3 HU, p = 0.04), and were also higher in men (PCATRCA: −80.5 ± 7.03 HU vs. −86.1 ± 7.08 HU, p < 0.001; PCATLesion: −79.6 ± 9.06 HU vs. −85.2 ± 7.96 HU, p = 0.02). Median time to ACS was 1.9 years, within a median follow-up of 5.3 years. PCATRCA alone was higher in HRP patients who subsequently presented with ACS (−76.8 ± 5.69 HU vs. −82.0 ± 6.32 HU, p = 0.03). In time-dependent analysis, ACS was associated with HRP and PCATRCA. Conclusions: PCAT attenuation is increased in stable CAD patients with HRP and is associated with subsequent ACS development. Further investigation is required to determine the clinical implications of these findings.

Effects of Serum LDL-C, CysC, and D-D in Patients with Coronary Atherosclerotic Heart Disease

“…It may interact with endothelial damage caused by high LDL-C, CysC, and DD and jointly promote the process of CHD [16,17]. erefore, regular detection of serum LDL-C, CysC, and D-D levels in patients with hypertension plays a signi cant role in evaluating the degree of target organ damage in cases with essential hypertension and the treatment and prognosis of hypertension [18,19].…”

“…It may interact with endothelial damage caused by high LDL-C, CysC, and DD and jointly promote the process of CHD [ 16 , 17 ]. Therefore, regular detection of serum LDL-C, CysC, and D-D levels in patients with hypertension plays a significant role in evaluating the degree of target organ damage in cases with essential hypertension and the treatment and prognosis of hypertension [ 18 , 19 ]. In addition, this study found that the AUC of the combination of LDL-C, CysC, and D-D for the diagnosis of CHD was 0.868, and the sensitivity and specificity were 88.89% and 73.33%, respectively, suggesting that the combination of the above three indicators has good diagnostic performance in CHD.…”

Vessel and sex differences in pericoronary adipose tissue attenuation obtained with coronary CT in individuals without coronary atherosclerosis

“…Previous studies mainly focused on the RCA to represent overall pericoronary attenuation, without evaluating potential differences between the RCA, LAD and LCx [6,15,[24][25][26]. The proximal RCA is characterized by the absence of confounding non-fatty structures such as side branches, coronary veins, or myocardium, and also by the highest volume of surrounding adipose tissue [4,27].…”

High-Risk Coronary Plaque Features: A Narrative Review

“…Right coronary artery peri-coronary adipose tissue attenuation is associated with CV risk factors and significant coronary stenoses [ 83 ]. Epicardial adipose tissue secretes adipocytokines, leading to a pro-inflammatory state and progression of atherosclerotic disease [ 21 , 84 , 85 ]. Therefore, the presence of peri-coronary adipose tissue especially around the right coronary artery is suggested as a promising imaging biomarker to allow non-invasive assessment of coronary inflammation.…”