Pericoronary fat attenuation in stenotic and vulnerable coronary artery plaques: Implications for coronary artery disease and associated conditions.

Abstract

Background: Pericoronary adipose tissue density (PCAT) is a parameter that quantifies inflammation and atherosclerosis around the coronary arteries.

Purpose: To investigate the correlation between PCAT and plaque features, stenosis degrees in coronary arteries (LAD, RCA, Cx) with stenotic vulnerable plaques.

Material and methods: A Retrospective study including 103 patients (64M, 39F) who underwent coronary computed tomography was retrospectively examined at a single center. PCAT and high-risk plaques were measured independently and compared to stenosis and coronary artery type. Adipose tissue attenuation, ranging from -180 to -25 HU, was measured along the plaque's length and in a 0.5-1 mm region around the perilesional coronary arteries.

Results: The PCAT values increases with the degree of stenosis in the LAD, Cx, and RCA (r = 0.9161, p < .001; r = 0.9717, p < .001; r = 0.9315, p < .001, respectively). PCAT values demonstrate a positive pattern when plaque length increases in all coronary arteries (r = -0.6316, p < .001; r = -0.8825, p < .001; r = -0.7529, p < .001; LAD, Cx, RCA). PCAT values differed significantly based on plaque type in all coronary arteries. Calcified plaques showed statistically significant differences compared to both soft and mixed plaques (p < .05). Patients with positive remodeling had PCAT values of -69.43 (±8.76) HU, while cases without positive remodeling had PCAT values of -84.54 (±7.65) HU, indicating a significant difference (p < .05).

Conclusion: The combined evaluation of plaque features, stenosis degree, and PCAT provides a more accurate prediction of possible acute coronary syndrome cases than analyzing stenosis degree alone.