Monash Cardiovascular Research Centre, Monash University and MonashHeart, Clayton, VIC 3800, Australia.
Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
Cells. 2021 May 10;10(5):1143. doi: 10.3390/cells10051143.
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).
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) and a per-lesion basis (PCAT) around HRP in cases and the highest-grade stenosis lesions in controls.
PCAT and PCAT were higher in HRP patients than controls (PCAT: -80.7 ± 6.50 HU vs. -84.2 ± 8.09 HU, = 0.03; PCAT: -79.6 ± 7.86 HU vs. -84.2 ± 10.3 HU, = 0.04), and were also higher in men (PCAT: -80.5 ± 7.03 HU vs. -86.1 ± 7.08 HU, < 0.001; PCAT: -79.6 ± 9.06 HU vs. -85.2 ± 7.96 HU, = 0.02). Median time to ACS was 1.9 years, within a median follow-up of 5.3 years. PCAT alone was higher in HRP patients who subsequently presented with ACS (-76.8 ± 5.69 HU vs. -82.0 ± 6.32 HU, = 0.03). In time-dependent analysis, ACS was associated with HRP and PCAT.
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.
冠状动脉计算机断层扫描血管造影（CTA）检测到的高危斑块（HRP）可增加急性冠状动脉综合征（ACS）的风险。冠状动脉周围脂肪组织衰减（PCAT）是冠状动脉炎症的一种新的生物标志物。本研究旨在评估 PCAT 与稳定型冠状动脉疾病（CAD）患者的 HRP 及随后 ACS 发展的相关性。
纳入 2011 年至 2016 年间接受冠状动脉 CTA 且具有可获得的结果数据的稳定型 CAD 患者。我们研究了 41 例 HRP 患者，将其与 41 例无 HRP 的对照患者进行倾向性匹配（60±10 岁，67%为男性）。使用半自动软件在每位患者的近端右冠状动脉（PCAT）和 HRP 周围的每处病变（PCAT）处评估 PCAT，在病例中为 HRP 最高分级狭窄病变，在对照中为最高分级狭窄病变。
HRP 患者的 PCAT 和 PCAT 均高于对照组（PCAT：-80.7±6.50 HU 比-84.2±8.09 HU， = 0.03；PCAT：-79.6±7.86 HU 比-84.2±10.3 HU， = 0.04），男性的 PCAT 也更高（PCAT：-80.5±7.03 HU 比-86.1±7.08 HU， < 0.001；PCAT：-79.6±9.06 HU 比-85.2±7.96 HU， = 0.02）。ACS 的中位时间为 1.9 年，中位随访时间为 5.3 年。随后出现 ACS 的 HRP 患者的 PCAT 更高（-76.8±5.69 HU 比-82.0±6.32 HU， = 0.03）。在时间依赖性分析中，ACS 与 HRP 和 PCAT 相关。
稳定型 CAD 患者 HRP 中存在 PCAT 衰减增加，与随后的 ACS 发展有关。需要进一步研究来确定这些发现的临床意义。
