Evaluating Pericoronary Adipose Tissue Attenuation to Predict Cardiovascular Events
Takahiro Nishihara, MD, PhD,
Toru Miyoshi, MD, PhD,
Kentaro Ejiri, MD, PhD,
Kazuhiro Osawa, MD, PhD,
Soichiro Fuke, MD, PhD,
Kousuke Seiyama, MD,
Masayuki Doi, MD, PhD,
Mitsutaka Nakashima, MD, PhD,
Takashi Miki, MD, PhD,
Shinsuke Yuasa, MD, PhD
Affiliations
Takahiro Nishihara, MD, PhD
Department of Cardiovascular Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
Toru Miyoshi, MD, PhD
Department of Cardiovascular Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan; Address for correspondence: Dr Toru Miyoshi, Department of Cardiovascular Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan.
Kentaro Ejiri, MD, PhD
Department of Cardiovascular Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
Kazuhiro Osawa, MD, PhD
Department of General Internal Medicine 3, Kawasaki Medical School General Medicine Center, Okayama, Japan
Soichiro Fuke, MD, PhD
Department of Cardiovascular Medicine, Japanese Red Cross Okayama Hospital, Okayama, Japan
Kousuke Seiyama, MD
Department of Cardiology, Kagawa Prefectural Central Hospital, Takamatsu, Japan
Masayuki Doi, MD, PhD
Department of Cardiology, Kagawa Prefectural Central Hospital, Takamatsu, Japan
Mitsutaka Nakashima, MD, PhD
Department of Cardiovascular Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
Takashi Miki, MD, PhD
Department of Cardiovascular Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
Shinsuke Yuasa, MD, PhD
Department of Cardiovascular Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
Background: Pericoronary adipose tissue attenuation (PCATA) is a novel imaging biomarker of pericoronary inflammation associated with coronary artery disease. Several studies have reported the usefulness of PCATA among people of European ethnicity; however, data are lacking concerning those of Asian ethnicity. Objectives: This multicenter study aimed to evaluate the effect of PCATA on prognosis in East Asian patients. Methods: Between August 2011 and December 2016, 2,172 patients underwent clinically indicated coronary computed tomography angiography (CTA) at 4 hospitals in Japan. Among them, 1,270 patients were analyzed. PCATA was evaluated using coronary CTA to measure pericoronary adipose tissue density surrounding the 3 major coronary arteries. The outcomes were composite cardiovascular events, including cardiovascular death and acute coronary syndrome; 33 cardiovascular events observed during a median follow-up of 6.0 years (Q1-Q3: 3.6-8.2 years). Results: Right coronary artery (RCA)-PCATA was significantly higher in patients with cardiovascular events than in those without (−63.7 ± 8.9 HU vs −67.4 ± 9.1 HU, respectively; P = 0.021). High RCA-PCATA was significantly associated with cardiovascular events in a model that included the Hisayama risk score and adverse coronary CTA findings (HR: 1.55; 95% CI: 1.07-2.24; P = 0.019). Conclusions: High RCA-PCATA showed significant association with future cardiovascular events after adjusting conventional risk factors and adverse coronary CTA findings in East Asian patients who underwent clinically indicated coronary CTA.
