Pre-percutaneous Coronary Intervention Pericoronary Adipose Tissue Attenuation Evaluated by Computed Tomography Predicts Global Coronary Flow Reserve After Urgent Revascularization in Patients With Non-ST-Segment-Elevation Acute Coronary Syndrome

• Published in: Journal of the American Heart Association 2020-09, Vol.9 (17), p.e016504-e016504
• Main Authors: Kanaji, Yoshihisa, Hirano, Hidenori, Sugiyama, Tomoyo, Hoshino, Masahiro, Horie, Tomoki, Misawa, Toru, Nogami, Kai, Ueno, Hiroki, Hada, Masahiro, Yamaguchi, Masao, Sumino, Yohei, Hamaya, Rikuta, Usui, Eisuke, Yonetsu, Taishi, Sasano, Tetsuo, Kakuta, Tsunekazu
• Format: Article
• Language: English
• Subjects: Acute Coronary Syndrome - diagnostic imaging; Acute Coronary Syndrome - physiopathology; Acute Coronary Syndrome - surgery; Adipose Tissue - diagnostic imaging; Adipose Tissue - pathology; Aged; Aged, 80 and over; Blood Flow Velocity - physiology; Computed Tomography Angiography - methods; coronary artery disease; coronary flow reserve; Coronary Vessels - diagnostic imaging; Coronary Vessels - physiopathology; Female; Humans; inflammation; Inflammation - physiopathology; Magnetic Resonance Imaging - methods; Male; Microcirculation - physiology; microvascular resistance; Middle Aged; Non-ST Elevated Myocardial Infarction - physiopathology; non–ST‐segment–elevation acute coronary syndrome; Original Research; Percutaneous Coronary Intervention - methods; Predictive Value of Tests; Prospective Studies; Tomography, X-Ray Computed - methods; Vascular Resistance - physiology
• ISSN: 2047-9980; 2047-9980
• DOI: 10.1161/JAHA.120.016504

Background Impaired global coronary flow reserve (g-CFR) is related to worse outcomes. Inflammation has been postulated to play a role in atherosclerosis. This study aimed to evaluate the relationship between pre-procedural pericoronary adipose tissue inflammation and g-CFR after the urgent percutaneous coronary intervention in patients with first non-ST-segment-elevation acute coronary syndrome. Methods and Results Phase-contrast cine-magnetic resonance imaging was performed to obtain g-CFR by quantifying coronary sinus flow at 1 month after percutaneous coronary intervention in a total of 116 first non-ST-segment-elevation acute coronary syndrome patients who underwent pre-percutaneous coronary intervention computed tomography angiography. On proximal 40-mm segments of 3 major coronary vessels on computed tomography angiography, pericoronary adipose tissue attenuation was assessed by the crude analysis of mean computed tomography attenuation value. The patients were divided into 2 groups with and without impaired g-CFR divided by the g-CFR value of 1.8. There were significant differences in age, culprit lesion location, N-terminal pro-B-type natriuretic peptide levels, high-sensitivity C-reactive protein (hs-CRP) levels, mean pericoronary adipose tissue attenuation between patients with impaired g-CFR and those without (g-CFR, 1.47 [1.16, 1.68] versus 2.66 [2.22, 3.28];