Lesion-specific pericoronary adipose tissue CT attenuation improves risk prediction of major adverse cardiovascular events in coronary artery disease

• Published in: British journal of radiology 2024-01, Vol.97 (1153), p.258-266
• Main Authors: Chen, Meng, Hao, Guangyu, Hu, Su, Chen, Can, Tao, Qing, Xu, Jialiang, Geng, Yayuan, Wang, Ximing, Hu, Chunhong
• Format: Article
• Language: English
• Subjects: Coronary Artery Disease; Epicardial Adipose Tissue; Humans; Retrospective Studies; Tomography, X-Ray Computed
• ISSN: 0007-1285; 1748-880X; 1748-880X
• DOI: 10.1093/bjr/tqad017

To determine whether lesion-specific pericoronary adipose tissue CT attenuation (PCATa) is superior to PCATa around the proximal right coronary artery (PCATa-RCA) and left anterior descending artery (PCATa-LAD) for major adverse cardiovascular events (MACE) prediction in coronary artery disease (CAD). Six hundred and eight CAD patients who underwent coronary CTA from January 2014 to December 2018 were retrospectively included, with clinical risk factors, plaque features, lesion-specific PCATa, PCATa-RCA, and PCATa-LAD collected. MACE was defined as cardiovascular death, non-fatal myocardial infarction, unplanned revascularization, and hospitalization for unstable angina. Four models were established, encapsulating traditional factors (Model A), traditional factors and PCATa-RCA (Model B), traditional factors and PCATa-LAD (Model C), and traditional factors and lesion-specific PCATa (Model D). Prognostic performance was evaluated with C-statistic, area under receiver operator characteristic curve (AUC), and net reclassification index (NRI). Lesion-specific PCATa was an independent predictor for MACE (adjusted hazard ratio = 1.108, P