Naniwa Shota, Kawamori Hiroyuki, Toba Takayoshi, Hiromasa Takashi, Sugizaki Yoichiro, Sasaki Satoru, Fujii Hiroyuki, Hamana Tomoyo, Osumi Yuto, Yamamoto Tetsuya, Iwane Seigo, Sakamoto Yuki, Matsuhama Koshi, Fukuishi Yuta, Tsunamoto Hiroshi, Higuchi Kotaro, Okamoto Hiroya, Iwasaki Masamichi, Takaya Tomofumi, Yamada Shinichiro, Hirata Ken-Ichi, Otake Hiromasa
Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
Department of Cardiology, Hyogo Prefectural Awaji Medical Center, Sumoto, Japan.
EuroIntervention. 2025 Jun 2;21(11):e605-e616. doi: 10.4244/EIJ-D-24-00971.
Pericoronary adipose tissue (PCAT) attenuation, measured using coronary computed tomography angiography (cCTA), is a potential marker of coronary inflammation.
We aimed to examine the association between coronary inflammation, as assessed by measuring PCAT attenuation before percutaneous coronary intervention (PCI), and clinical outcomes of PCI using current-generation drug-eluting stents (DES).
We retrospectively studied consecutive patients who underwent cCTA before PCI with current-generation DES. Adverse plaque characteristics, calcified plaque (CP) burden, and PCAT attenuation of the proximal right coronary artery (PCAT) were assessed using cCTA. The primary outcome was a patient-oriented composite endpoint (PoCE), including cardiovascular death, non-fatal myocardial infarction, any revascularisation, and stroke.
During a median follow-up of 1,540 days, 77 of 490 patients experienced PoCE. Patients with PoCE had higher PCAT (-76.3±6.4 Hounsfield units [HU] vs -82.5±8.1 HU; p<0.001). Multivariable analysis showed that the presence of adverse plaque, greater CP burden and higher PCAT were independently associated with PoCE (hazard ratio [HR] 2.05, 95% confidence interval [CI]: 1.26-3.34; p=0.004; HR 1.04, 95% CI: 1.02-1.07; p=0.002; and HR 2.20, 95% CI: 1.63-2.97; p<0.001, respectively). PoCE incidence was 3.9 times higher in patients with high PCAT (≥-79.9 HU) than those with low PCAT (.
使用冠状动脉计算机断层扫描血管造影（cCTA）测量的冠状动脉周围脂肪组织（PCAT）衰减是冠状动脉炎症的一个潜在标志物。
我们旨在研究在经皮冠状动脉介入治疗（PCI）前通过测量PCAT衰减评估的冠状动脉炎症与使用当代药物洗脱支架（DES）的PCI临床结局之间的关联。
我们回顾性研究了在接受当代DES进行PCI前接受cCTA的连续患者。使用cCTA评估不良斑块特征、钙化斑块（CP）负荷以及右冠状动脉近端的PCAT衰减。主要结局是一个以患者为导向的复合终点（PoCE），包括心血管死亡、非致命性心肌梗死、任何血管重建和中风。
在中位随访1540天期间，490例患者中有77例发生PoCE。发生PoCE的患者PCAT更高（-76.3±6.4亨氏单位[HU]对-82.5±8.1 HU；p<0.001）。多变量分析显示，不良斑块的存在、更大的CP负荷和更高的PCAT与PoCE独立相关（风险比[HR] 2.05，95%置信区间[CI]：1.26 - 3.34；p = 0.004；HR 1.04，95% CI：1.02 - 1.07；p = 0.002；以及HR 2.20，95% CI：1.63 - 2.97；p<0.001，分别）。PCAT高（≥ - 79.9 HU）的患者PoCE发生率比PCAT低的患者高3.9倍（。
