Nishihara Takahiro, Miyoshi Toru, Ejiri Kentaro, Osawa Kazuhiro, Fuke Soichiro, Seiyama Kousuke, Doi Masayuki, Nakashima Mitsutaka, Miki Takashi, Yuasa Shinsuke
Department of Cardiovascular Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
Department of General Internal Medicine 3, Kawasaki Medical School General Medicine Center, Okayama, Japan.
JACC Asia. 2024 Nov 12;5(1):1-11. doi: 10.1016/j.jacasi.2024.09.009. eCollection 2025 Jan.
Pericoronary adipose tissue attenuation (PCATA) is a novel imaging biomarker of pericoronary inflammation associated with coronary artery disease. Several studies have reported the usefulness of PCATA among people of European ethnicity; however, data are lacking concerning those of Asian ethnicity.
This multicenter study aimed to evaluate the effect of PCATA on prognosis in East Asian patients.
Between August 2011 and December 2016, 2,172 patients underwent clinically indicated coronary computed tomography angiography (CTA) at 4 hospitals in Japan. Among them, 1,270 patients were analyzed. PCATA was evaluated using coronary CTA to measure pericoronary adipose tissue density surrounding the 3 major coronary arteries. The outcomes were composite cardiovascular events, including cardiovascular death and acute coronary syndrome; 33 cardiovascular events observed during a median follow-up of 6.0 years (Q1-Q3: 3.6-8.2 years).
Right coronary artery (RCA)-PCATA was significantly higher in patients with cardiovascular events than in those without (-63.7 ± 8.9 HU vs -67.4 ± 9.1 HU, respectively; 0.021). High RCA-PCATA was significantly associated with cardiovascular events in a model that included the Hisayama risk score and adverse coronary CTA findings (HR: 1.55; 95% CI: 1.07-2.24; 0.019).
High RCA-PCATA showed significant association with future cardiovascular events after adjusting conventional risk factors and adverse coronary CTA findings in East Asian patients who underwent clinically indicated coronary CTA.
冠状动脉周围脂肪组织衰减（PCATA）是一种与冠状动脉疾病相关的冠状动脉炎症的新型成像生物标志物。多项研究报道了PCATA在欧洲种族人群中的有用性；然而，缺乏关于亚洲种族人群的相关数据。
这项多中心研究旨在评估PCATA对东亚患者预后的影响。
在2011年8月至2016年12月期间，2172例患者在日本的4家医院接受了临床指征的冠状动脉计算机断层扫描血管造影（CTA）检查。其中，对1270例患者进行了分析。使用冠状动脉CTA评估PCATA，以测量三大冠状动脉周围的冠状动脉周围脂肪组织密度。观察终点为复合心血管事件，包括心血管死亡和急性冠状动脉综合征；在中位随访6.0年（四分位间距：3.6 - 8.2年）期间观察到33例心血管事件。
发生心血管事件的患者右冠状动脉（RCA）-PCATA显著高于未发生心血管事件的患者（分别为-63.7±8.9 HU和-67.4±9.1 HU；P = 0.021）。在包含久山风险评分和不良冠状动脉CTA表现的模型中，高RCA-PCATA与心血管事件显著相关（风险比：1.55；95%置信区间：1.07 - 2.24；P = 0.019）。
在接受临床指征冠状动脉CTA的东亚患者中，调整传统危险因素和不良冠状动脉CTA表现后，高RCA-PCATA与未来心血管事件显著相关。
