Impact of pericoronary adipose tissue attenuation on clinical outcomes after percutaneous coronary intervention.

BACKGROUND

Pericoronary adipose tissue (PCAT) attenuation, measured using coronary computed tomography angiography (cCTA), is a potential marker of coronary inflammation.

AIMS

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).

METHODS

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.

RESULTS

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 (.