Pericoronary fat attenuation in stenotic and vulnerable coronary artery plaques: Implications for coronary artery disease and associated conditions.

BACKGROUND

Pericoronary adipose tissue density (PCAT) is a parameter that quantifies inflammation and atherosclerosis around the coronary arteries.

PURPOSE

To investigate the correlation between PCAT and plaque features, stenosis degrees in coronary arteries (LAD, RCA, Cx) with stenotic vulnerable plaques.

MATERIAL AND METHODS

A Retrospective study including 103 patients (64M, 39F) who underwent coronary computed tomography was retrospectively examined at a single center. PCAT and high-risk plaques were measured independently and compared to stenosis and coronary artery type. Adipose tissue attenuation, ranging from -180 to -25 HU, was measured along the plaque's length and in a 0.5-1 mm region around the perilesional coronary arteries.

RESULTS

The PCAT values increases with the degree of stenosis in the LAD, Cx, and RCA (r = 0.9161, < .001; r = 0.9717, < .001; r = 0.9315, < .001, respectively). PCAT values demonstrate a positive pattern when plaque length increases in all coronary arteries (r = -0.6316, < .001; r = -0.8825, < .001; r = -0.7529, < .001; LAD, Cx, RCA). PCAT values differed significantly based on plaque type in all coronary arteries. Calcified plaques showed statistically significant differences compared to both soft and mixed plaques ( < .05). Patients with positive remodeling had PCAT values of -69.43 (±8.76) HU, while cases without positive remodeling had PCAT values of -84.54 (±7.65) HU, indicating a significant difference ( < .05).

CONCLUSION

The combined evaluation of plaque features, stenosis degree, and PCAT provides a more accurate prediction of possible acute coronary syndrome cases than analyzing stenosis degree alone.