Highlights
- •The CT value of non-contrast CT (NC-PCAT) is correlated with that of conventional pericoronary adipose tissue (PCAT) .
- •High NC-PCAT value is associated with presence of high-risk plaque.
- •NC-PCAT is a significant predictor of worse clinical outcome in coronary artery disease patients.
Abstract
Background and aims
We aimed to develop a method for quantifying pericoronary adipose tissue (PCAT) on
electrocardiogram (ECG)-gated non-contrast CT (NC-PCAT) and validate its efficacy
and prognostic value.
Methods
We retrospectively studied two independent cohorts. PCAT was quantified conventionally.
NC-PCAT was defined as the mean CT value of epicardial fat tissue adjacent to right
coronary artery ostium on ECG-gated non-contrast CT. In cohort 1 (n = 300), we evaluated
the correlation of two methods and the association between NC-PCAT and CT-verified
high-risk plaque (HRP). We dichotomized cohort 2 (n = 333) by the median of NC-PCAT,
and assessed the prognostic value of NC-PCAT for primary endpoint (all-cause death
and non-fatal myocardial infarction) by Cox regression analysis. The median duration
of follow-up was 2.9 years.
Results
NC-PCAT was correlated with PCAT (r = 0.68, p<0.0001). In multivariable logistic regression analysis, high NC-PCAT (OR:1.06; 95%CI:1.03–1.10;
p = 0.0001), coronary artery calcium score (CACS) (OR:1.01 per 10 CACS increase, 95%CI:1.00–1.02;
p = 0.013), and current smoking (OR:2.58; 95%CI:1.03–6.49; p = 0.044) were independent predictors of HRP. Among patients with CACS>0 (n = 193),
NC-PCAT (OR:1.06; 95%CI:1.03–1.10; p = 0.0002), current smoking (OR:3.02; 95%CI:1.17–7.82; p = 0.027), and male sex (OR:2.81; 95%CI:1.06–7.48; p = 0.028) were independent predictors of HRP, whereas CACS was not (p = 0.15). Multivariable Cox regression analysis revealed high NC-PCAT as an independent
predictor of the primary endpoint, even after adjustment for sex and age (HR:4.3;
95%CI:1.2–15.2; p = 0.012).
Conclusions
There was a positive correlation between NC-PCAT and PCAT, with high NC-PCAT significantly
associated with worse clinical outcome (independent of CACS) as well as presence of
HRP.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: January 30, 2023
Accepted:
January 24,
2023
Received in revised form:
December 16,
2022
Received:
September 28,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier B.V. All rights reserved.
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- No contrast? No problem! Value in assessing pericoronary fat in non-contrast studiesAtherosclerosis
- PreviewIn this issue of Atherosclerosis, Takahashi et al. present a novel method for quantifying pericoronary adipose tissue (PCAT) attenuation on non-contrast chest computed tomography (NC-PCAT) scans performed for coronary artery calcium score (CACS) assessment. They also assessed its efficacy and utility as a prognostic tool [1]. The authors divided the study population into two cohorts. Cohort 1 (N = 300 consecutive patients with previous CCTA) was used to assess the correlation between PCAT on non-contrast chest CT and coronary CT angiography (CCTA) and then the association between NC-PCAT and high-risk plaques (HRP).
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