Pericoronary adipose tissue for predicting long-term outcomes

European Heart Journal - Cardiovascular Imaging, vol. 25, pp. 1351–1359

Abstract

AIMS: Pericoronary adipose tissue (PCAT) attenuation obtained by coronary computed tomography angiography (CCTA) has been associated with coronary inflammation and outcomes. Whether PCAT attenuation is predictive of major adverse cardiac events (MACE) during long-term follow-up is unknown. METHODS AND RESULTS: Symptomatic patients with coronary artery disease (CAD) who underwent CCTA were included, and clinical outcomes were evaluated. PCAT was measured at all lesions for all three major coronary arteries using semi-automated software. A comparison between patients with and without MACE was made on both a per-lesion and a per-patient level. The predictive value of PCAT attenuation for MACE was assessed in Cox regression models. In 483 patients (63.3 ± 8.5 years, 54.9% men), 1561 lesions were analysed over a median follow-up duration of 9.5 years. The mean PCAT attenuation was not significantly different between patients with and without MACE. At a per-patient level, the adjusted hazard ratio (HR) and 95% confidence interval (CI) for MACE were 0.970 (95% CI: 0.933-1.008, P = 0.121) when the average of all lesions per patient was analysed, 0.992 (95% CI: 0.961-1.024, P = 0.622) when only the most obstructive lesion was evaluated, and 0.981 (95% CI: 0.946-1.016, P = 0.285) when only the lesion with the highest PCAT attenuation per individual was evaluated. Adjusted HRs for vessel-specific PCAT attenuation in the right coronary artery, left anterior descending artery, and left circumflex artery were 0.957 (95% CI: 0.830-1.104, P = 0.548), 0.989 (95% CI: 0.954-1.025, P = 0.550), and 0.739 (95% CI: 0.293-1.865, P = 0.522), respectively, in predicting long-term MACE. CONCLUSION: In patients referred to CCTA for clinically suspected CAD, PCAT attenuation did not predict MACE during long-term follow-up.

Authors 9

1. Sophie E. van Rosendael Aachen Department of Cardiology, Leiden University Medical Center

   Leiden University Medical Center

   Affiliation as printed

   Department of Cardiology, Leiden University Medical Center , Albinusdreef 2, 2333ZA Leiden ,

   Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333ZA Leiden, The Netherlands

2. Vasileios Kamperidis

   Aristotle University of Thessaloniki · AHEPA University Hospital

   Affiliation as printed

   First Department of Cardiology, Medical School, AHEPA Hospital, Aristotle University of Thessaloniki , , St. Kiriakidi 1, Thessaloniki GR-54636 ,

   First Department of Cardiology, Medical School, AHEPA Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, Thessaloniki GR-54636, Greece

3. Teemu Maaniitty

   University of Turku · Turku University Hospital · Turku PET Centre

   Affiliation as printed

   Turku PET Centre, Turku University Hospital and University of Turku , Turku ,

   Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland

4. Michiel A. de Graaf Aachen Department of Cardiology, Leiden University Medical Center

   Leiden University Medical Center

   Affiliation as printed

   Department of Cardiology, Leiden University Medical Center , Albinusdreef 2, 2333ZA Leiden ,

   Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333ZA Leiden, The Netherlands

5. Antti Saraste

   University of Turku · Turku University Hospital · Turku PET Centre

   Affiliation as printed

   Heart Center, Turku University Hospital and University of Turku , Turku ,

   Turku PET Centre, Turku University Hospital and University of Turku , Turku ,

   Heart Center, Turku University Hospital and University of Turku, Turku, Finland

   Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland

6. George E McKay-Goodall

   UNSW Sydney · St Vincent's Hospital Sydney

   Affiliation as printed

   St. Vincent’s Hospital Sydney, University of New South Wales Medical School , Sydney, NSW ,

   St. Vincent's Hospital Sydney, University of New South Wales Medical School, Sydney, NSW, Australia

7. J. Wouter Jukema Aachen Department of Cardiology, Leiden University Medical Center

   Leiden University Medical Center · Netherlands Heart Institute

   Affiliation as printed

   Department of Cardiology, Leiden University Medical Center , Albinusdreef 2, 2333ZA Leiden ,

   Netherlands Heart Institute , Utrecht ,

   Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333ZA Leiden, The Netherlands

   Netherlands Heart Institute, Utrecht, The Netherlands

8. Juhani M. Knuuti

   University of Turku · Turku University Hospital · Turku PET Centre

   Affiliation as printed

   Turku PET Centre, Turku University Hospital and University of Turku , Turku ,

   Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland

9. JEROEN J. BAX corresponding Aachen Department of Cardiology, Leiden University Medical Center

   Leiden University Medical Center

   Affiliation as printed

   Department of Cardiology, Leiden University Medical Center , Albinusdreef 2, 2333ZA Leiden ,

   Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333ZA Leiden, The Netherlands