TY - JOUR
T1 - Perivascular fat attenuation for predicting adverse cardiac events in stable patients undergoing invasive coronary angiography
AU - Chatterjee, Devina
AU - Shou, Benjamin L.
AU - Matheson, Matthew B.
AU - Ostovaneh, Mohammad R.
AU - Rochitte, Carlos
AU - Chen, Marcus Y.
AU - Dewey, Marc
AU - Ortman, Jason
AU - Cox, Christopher
AU - Lima, Joao A.C.
AU - Arbab-Zadeh, Armin
N1 - Publisher Copyright:
© 2022 Society of Cardiovascular Computed Tomography
PY - 2022/11/1
Y1 - 2022/11/1
N2 - 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.
AB - 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.
KW - Coronary artery disease
KW - Coronary computed tomography angiography
KW - Coronary heart disease
KW - Multidetector computed tomography
KW - Perivascular fat attenuation
UR - http://www.scopus.com/inward/record.url?scp=85132553957&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85132553957&partnerID=8YFLogxK
U2 - 10.1016/j.jcct.2022.05.004
DO - 10.1016/j.jcct.2022.05.004
M3 - Article
C2 - 35680534
AN - SCOPUS:85132553957
SN - 1934-5925
VL - 16
SP - 483
EP - 490
JO - Journal of cardiovascular computed tomography
JF - Journal of cardiovascular computed tomography
IS - 6
ER -