Pericoronary Adipose Tissue Attenuation Is Associated with High-Risk Plaque and Subsequent Acute Coronary Syndrome in Patients with Stable Coronary Artery Disease
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...
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MDPI AG
2021-05-01
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| Online Access: | https://www.mdpi.com/2073-4409/10/5/1143 |
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| author | Jeremy Yuvaraj Andrew Lin Nitesh Nerlekar Ravi K. Munnur James D. Cameron Damini Dey Stephen J. Nicholls Dennis T. L. Wong |
| author_facet | Jeremy Yuvaraj Andrew Lin Nitesh Nerlekar Ravi K. Munnur James D. Cameron Damini Dey Stephen J. Nicholls Dennis T. L. Wong |
| author_sort | Jeremy Yuvaraj |
| collection | DOAJ |
| description | 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 (PCAT<sub>RCA</sub>) and a per-lesion basis (PCAT<sub>Lesion</sub>) around HRP in cases and the highest-grade stenosis lesions in controls. Results: PCAT<sub>RCA</sub> and PCAT<sub>Lesion</sub> were higher in HRP patients than controls (PCAT<sub>RCA</sub>: −80.7 ± 6.50 HU vs. −84.2 ± 8.09 HU, <i>p</i> = 0.03; PCAT<sub>Lesion</sub>: −79.6 ± 7.86 HU vs. −84.2 ± 10.3 HU, <i>p</i> = 0.04), and were also higher in men (PCAT<sub>RCA</sub>: −80.5 ± 7.03 HU vs. −86.1 ± 7.08 HU, <i>p</i> < 0.001; PCAT<sub>Lesion</sub>: −79.6 ± 9.06 HU vs. −85.2 ± 7.96 HU, <i>p</i> = 0.02). Median time to ACS was 1.9 years, within a median follow-up of 5.3 years. PCAT<sub>RCA</sub> alone was higher in HRP patients who subsequently presented with ACS (−76.8 ± 5.69 HU vs. −82.0 ± 6.32 HU, <i>p</i> = 0.03). In time-dependent analysis, ACS was associated with HRP and PCAT<sub>RCA</sub>. 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. |
| first_indexed | 2024-03-10T11:34:27Z |
| format | Article |
| id | doaj.art-3678a2577fee4191b5d11144a18d39bf |
| institution | Directory Open Access Journal |
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| language | English |
| last_indexed | 2024-03-10T11:34:27Z |
| publishDate | 2021-05-01 |
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| spelling | doaj.art-3678a2577fee4191b5d11144a18d39bf2023-11-21T18:56:21ZengMDPI AGCells2073-44092021-05-01105114310.3390/cells10051143Pericoronary Adipose Tissue Attenuation Is Associated with High-Risk Plaque and Subsequent Acute Coronary Syndrome in Patients with Stable Coronary Artery DiseaseJeremy Yuvaraj0Andrew Lin1Nitesh Nerlekar2Ravi K. Munnur3James D. Cameron4Damini Dey5Stephen J. Nicholls6Dennis T. L. Wong7Monash Cardiovascular Research Centre, Monash University and MonashHeart, Clayton, VIC 3800, AustraliaBiomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USAMonash Cardiovascular Research Centre, Monash University and MonashHeart, Clayton, VIC 3800, AustraliaMonash Cardiovascular Research Centre, Monash University and MonashHeart, Clayton, VIC 3800, AustraliaMonash Cardiovascular Research Centre, Monash University and MonashHeart, Clayton, VIC 3800, AustraliaBiomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USAMonash Cardiovascular Research Centre, Monash University and MonashHeart, Clayton, VIC 3800, AustraliaMonash Cardiovascular Research Centre, Monash University and MonashHeart, Clayton, VIC 3800, AustraliaBackground: 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 (PCAT<sub>RCA</sub>) and a per-lesion basis (PCAT<sub>Lesion</sub>) around HRP in cases and the highest-grade stenosis lesions in controls. Results: PCAT<sub>RCA</sub> and PCAT<sub>Lesion</sub> were higher in HRP patients than controls (PCAT<sub>RCA</sub>: −80.7 ± 6.50 HU vs. −84.2 ± 8.09 HU, <i>p</i> = 0.03; PCAT<sub>Lesion</sub>: −79.6 ± 7.86 HU vs. −84.2 ± 10.3 HU, <i>p</i> = 0.04), and were also higher in men (PCAT<sub>RCA</sub>: −80.5 ± 7.03 HU vs. −86.1 ± 7.08 HU, <i>p</i> < 0.001; PCAT<sub>Lesion</sub>: −79.6 ± 9.06 HU vs. −85.2 ± 7.96 HU, <i>p</i> = 0.02). Median time to ACS was 1.9 years, within a median follow-up of 5.3 years. PCAT<sub>RCA</sub> alone was higher in HRP patients who subsequently presented with ACS (−76.8 ± 5.69 HU vs. −82.0 ± 6.32 HU, <i>p</i> = 0.03). In time-dependent analysis, ACS was associated with HRP and PCAT<sub>RCA</sub>. 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.https://www.mdpi.com/2073-4409/10/5/1143coronary computed tomography angiographyatherosclerosiscoronary artery diseasehigh-risk plaqueacute coronary syndromepericoronary adipose tissue |
| spellingShingle | Jeremy Yuvaraj Andrew Lin Nitesh Nerlekar Ravi K. Munnur James D. Cameron Damini Dey Stephen J. Nicholls Dennis T. L. Wong Pericoronary Adipose Tissue Attenuation Is Associated with High-Risk Plaque and Subsequent Acute Coronary Syndrome in Patients with Stable Coronary Artery Disease Cells coronary computed tomography angiography atherosclerosis coronary artery disease high-risk plaque acute coronary syndrome pericoronary adipose tissue |
| title | Pericoronary Adipose Tissue Attenuation Is Associated with High-Risk Plaque and Subsequent Acute Coronary Syndrome in Patients with Stable Coronary Artery Disease |
| title_full | Pericoronary Adipose Tissue Attenuation Is Associated with High-Risk Plaque and Subsequent Acute Coronary Syndrome in Patients with Stable Coronary Artery Disease |
| title_fullStr | Pericoronary Adipose Tissue Attenuation Is Associated with High-Risk Plaque and Subsequent Acute Coronary Syndrome in Patients with Stable Coronary Artery Disease |
| title_full_unstemmed | Pericoronary Adipose Tissue Attenuation Is Associated with High-Risk Plaque and Subsequent Acute Coronary Syndrome in Patients with Stable Coronary Artery Disease |
| title_short | Pericoronary Adipose Tissue Attenuation Is Associated with High-Risk Plaque and Subsequent Acute Coronary Syndrome in Patients with Stable Coronary Artery Disease |
| title_sort | pericoronary adipose tissue attenuation is associated with high risk plaque and subsequent acute coronary syndrome in patients with stable coronary artery disease |
| topic | coronary computed tomography angiography atherosclerosis coronary artery disease high-risk plaque acute coronary syndrome pericoronary adipose tissue |
| url | https://www.mdpi.com/2073-4409/10/5/1143 |
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