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Article

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

1
Monash Cardiovascular Research Centre, Monash University and MonashHeart, Clayton, VIC 3800, Australia
2
Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
3
South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
*
Author to whom correspondence should be addressed.
Academic Editor: Sanjay Patel
Cells 2021, 10(5), 1143; https://doi.org/10.3390/cells10051143
Received: 30 March 2021 / Revised: 28 April 2021 / Accepted: 6 May 2021 / Published: 10 May 2021
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. View Full-Text
Keywords: coronary computed tomography angiography; atherosclerosis; coronary artery disease; high-risk plaque; acute coronary syndrome; pericoronary adipose tissue coronary computed tomography angiography; atherosclerosis; coronary artery disease; high-risk plaque; acute coronary syndrome; pericoronary adipose tissue
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MDPI and ACS Style

Yuvaraj, J.; Lin, A.; Nerlekar, N.; Munnur, R.K.; Cameron, J.D.; Dey, D.; Nicholls, S.J.; Wong, D.T.L. Pericoronary Adipose Tissue Attenuation Is Associated with High-Risk Plaque and Subsequent Acute Coronary Syndrome in Patients with Stable Coronary Artery Disease. Cells 2021, 10, 1143. https://doi.org/10.3390/cells10051143

AMA Style

Yuvaraj J, Lin A, Nerlekar N, Munnur RK, Cameron JD, Dey D, Nicholls SJ, Wong DTL. Pericoronary Adipose Tissue Attenuation Is Associated with High-Risk Plaque and Subsequent Acute Coronary Syndrome in Patients with Stable Coronary Artery Disease. Cells. 2021; 10(5):1143. https://doi.org/10.3390/cells10051143

Chicago/Turabian Style

Yuvaraj, Jeremy, Andrew Lin, Nitesh Nerlekar, Ravi K. Munnur, James D. Cameron, Damini Dey, Stephen J. Nicholls, and Dennis T.L. Wong 2021. "Pericoronary Adipose Tissue Attenuation Is Associated with High-Risk Plaque and Subsequent Acute Coronary Syndrome in Patients with Stable Coronary Artery Disease" Cells 10, no. 5: 1143. https://doi.org/10.3390/cells10051143

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