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

IF 9.5 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Eurointervention Pub Date : 2025-06-02 DOI:10.4244/EIJ-D-24-00971

Shota Naniwa, Hiroyuki Kawamori, Takayoshi Toba, Takashi Hiromasa, Yoichiro Sugizaki, Satoru Sasaki, Hiroyuki Fujii, Tomoyo Hamana, Yuto Osumi, Tetsuya Yamamoto, Seigo Iwane, Yuki Sakamoto, Koshi Matsuhama, Yuta Fukuishi, Hiroshi Tsunamoto, Kotaro Higuchi, Hiroya Okamoto, Masamichi Iwasaki, Tomofumi Takaya, Shinichiro Yamada, Ken-Ichi Hirata, Hiromasa Otake

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Abstract

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_RCA) 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_RCA (-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_RCA 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_RCA (≥-79.9 HU) than those with low PCAT_RCA (.

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冠状动脉周围脂肪组织衰减对经皮冠状动脉介入治疗后临床结果的影响。

背景：冠状动脉ct血管造影（cCTA）测量冠状动脉周围脂肪组织（PCAT）衰减，是冠状动脉炎症的潜在标志。目的：我们旨在研究冠状动脉炎症（经皮冠状动脉介入治疗（PCI）前通过测量PCAT衰减来评估）与使用当代药物洗脱支架（DES）的PCI临床结果之间的关系。方法：我们回顾性研究了在PCI前连续接受cCTA的当代DES患者，使用cCTA评估不良斑块特征、钙化斑块（CP）负担和右近端冠状动脉（PCATRCA）的PCAT衰减。主要终点为以患者为导向的复合终点（PoCE），包括心血管死亡、非致死性心肌梗死、任何血运重建和卒中。结果：在中位随访1540天期间，490例患者中有77例发生了PoCE。pce患者的PCATRCA较高(-76.3±6.4 Hounsfield单位[HU] vs -82.5±8.1 HU；pRCA与PoCE独立相关(风险比[HR] 2.05, 95%可信区间[CI]: 1.26-3.34；p = 0.004;Hr 1.04, 95% ci: 1.02-1.07；p = 0.002;HR 2.20, 95% CI: 1.63 ~ 2.97；pRCA（≥-79.9 HU）高于低PCATRCA组（≥-79.9 HU）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Eurointervention CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

10.30

自引率

4.80%

发文量

380

审稿时长

3-8 weeks

期刊介绍： EuroIntervention Journal is an international, English language, peer-reviewed journal whose aim is to create a community of high quality research and education in the field of percutaneous and surgical cardiovascular interventions.