Pericoronary adipose tissue attenuation, low-attenuation plaque burden and 5-year risk of myocardial infarction
| Autor: | Kajetan Grodecki, Andrew Lin, Chengjia Wang, Nicholas L. Mills, Jacek Kwiecinski, Shirjel Alam, P. Adamson, Jonathan R. Weir-McCall, Priscilla McElhinney, E. J. R. Van Beek, Tania Pawade, Anoop S V Shah, Amanda Hunter, Leslee J. Shaw, Edward D. Nicol, Michelle A. Williams, Evangelos Tzolos, Piotr J. Slomka, David E. Newby, Mhairi Doris, F T Guadalupe, Sebastien Cadet, Damini Dey, A. Moss, D. Berman, M R Dweck, G. Roditi |
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| Přispěvatelé: | Weir-McCall, Jonathan [0000-0001-5842-842X], Apollo - University of Cambridge Repository |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
pericoronary adipose tissue
medicine.medical_specialty Computed Tomography Angiography Myocardial Infarction Adipose tissue risk stratification Coronary Artery Disease Coronary Angiography Myocardial Infarction/diagnostic imaging Predictive Value of Tests Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Myocardial infarction noncalcified plaque burden Aged Coronary Angiography/methods Computed Tomography Angiography/methods Adipose Tissue/diagnostic imaging business.industry Attenuation low-attenuation noncalcified plaque burden Middle Aged medicine.disease Plaque Atherosclerotic Adipose Tissue Cardiology business Cardiology and Cardiovascular Medicine Coronary Artery Disease/diagnostic imaging |
| Zdroj: | Tzolos, E, Williams, M C, McElhinney, P, Lin, A, Grodecki, K, Flores Tomasino, G, Cadet, S, Kwiecinski, J, Doris, M, Adamson, P D, Moss, A J, Alam, S, Hunter, A, Shah, A S V, Mills, N L, Pawade, T, Wang, C, Weir-McCall, J R, Roditi, G, van Beek, E J R, Shaw, L J, Nicol, E D, Berman, D S, Slomka, P J, Dweck, M R, Newby, D E & Dey, D 2022, ' Pericoronary adipose tissue attenuation, low-attenuation plaque burden and 5-year risk of myocardial infarction ', JACC: Cardiovascular Imaging, vol. 15, no. 6, pp. 1078-1088 . https://doi.org/10.1016/j.jcmg.2022.02.004 |
| ISSN: | 1936-878X |
| DOI: | 10.1016/j.jcmg.2022.02.004 |
| Popis: | Background: Pericoronary adipose tissue (PCAT) attenuation and low-attenuation noncalcified plaque (LAP) burden can both predict outcomes. Objectives: This study sought to assess the relative and additive values of PCAT attenuation and LAP to predict future risk of myocardial infarction. Methods: In a post hoc analysis of the multicenter SCOT-HEART (Scottish Computed Tomography of the Heart) trial, the authors investigated the relationships between the future risk of fatal or nonfatal myocardial infarction and PCAT attenuation measured from coronary computed tomography angiography (CTA) using multivariable Cox regression models including plaque burden, obstructive coronary disease, and cardiac risk score (incorporating age, sex, diabetes, smoking, hypertension, hyperlipidemia, and family history). Results: In 1,697 evaluable participants (age: 58 ± 10 years), there were 37 myocardial infarctions after a median follow-up of 4.7 years. Mean PCAT was −76 ± 8 HU and median LAP burden was 4.20% (IQR: 0%-6.86%). PCAT attenuation of the right coronary artery (RCA) was predictive of myocardial infarction (HR: 1.55; P = 0.017, per 1 SD increment) with an optimum threshold of −70.5 HU (HR: 2.45; P = 0.01). In multivariable analysis, adding PCAT-RCA of ≥−70.5 HU to an LAP burden of >4% (the optimum threshold for future myocardial infarction; HR: 4.87; P < 0.0001) led to improved prediction of future myocardial infarction (HR: 11.7; P < 0.0001). LAP burden showed higher area under the curve compared to PCAT attenuation for the prediction of myocardial infarction (AUC = 0.71 [95% CI: 0.62-0.80] vs AUC = 0.64 [95% CI: 0.54-0.74]; P < 0.001), with increased area under the curve when the 2 metrics are combined (AUC = 0.75 [95% CI: 0.65-0.85]; P = 0.037). Conclusion: Coronary CTA–defined LAP burden and PCAT attenuation have marked and complementary predictive value for the risk of fatal or nonfatal myocardial infarction. |
| Databáze: | OpenAIRE |
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