TY - JOUR
T1 - Epicardial and paracardial adipose tissue volume and attenuation - Association with high-risk coronary plaque on computed tomographic angiography in the ROMICAT II trial
AU - Lu, Michael T.
AU - Park, Jakob
AU - Ghemigian, Khristine
AU - Mayrhofer, Thomas
AU - Puchner, Stefan B.
AU - Liu, Ting
AU - Fleg, Jerome L.
AU - Udelson, James E.
AU - Truong, Quynh A.
AU - Ferencik, Maros
AU - Hoffmann, Udo
N1 - Funding Information:
The authors acknowledge NIH 5T32HL076136 , the MGH Executive Committee on Research and the American Roentgen Ray Society Scholarship (MTL), the German Cardiac Society and German National Academic Foundation (JP), the American Heart Association 13FTF16450001 (MF), Siemens Healthcare , NIH / NHLBI 5K24HL113128 and 5U01HL092040-04 (UH).
Publisher Copyright:
© 2016 Elsevier Ireland Ltd.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Background and aims: To determine whether epicardial (EAT) and paracardial adipose tissue (PAT) volume and attenuation are associated with high-risk coronary plaque features. Methods: In subjects with suspected acute coronary syndrome (ACS) enrolled in the ROMICAT II trial, EAT and PAT volumes indexed to body surface area (BSA) and attenuation were measured on non-contrast coronary artery calcium score (CACS) CT. High-risk plaque features (napkin-ring sign, positive remodeling, low density plaque, spotty calcium) and stenosis were assessed on coronary CT angiography (CTA). The association of EAT and PAT volume and attenuation with high-risk plaque and whether this was independent of clinical risk assessment, CACS and significant coronary artery disease (CAD) was determined. Results: Of 467 (mean 54 ± 8 yrs, 53% male) with CACS and CTA, 167 (36%) had high-risk plaque features. Those with high-risk plaque had significantly higher indexed EAT (median 59 (Q1-Q3:45-75) cc/m2 vs. 49 (35-65) cc/m2, p < 0.001) and PAT volume (median:51 (36-73) cc/m2 vs. 33 (22-52) cc/m2, p < 0.001). Higher indexed EAT volume was associated with high-risk plaque [univariate OR 1.02 (95%-CI:1.01-1.03) per cc/m2 of EAT, p < 0.001], which remained significant [univariate OR 1.04 (95%-CI:1.00-1.08) per cc/m2 of EAT, p = 0.040] after adjustment for risk factors, CACS, and stenosis ≥50%. Higher indexed PAT volume was associated with high-risk plaque in univariate analysis [OR 1.02 (1.01-1.03) per cc/m2 of PAT, p < 0.001], though this was not significant in multivariate analysis. At a threshold of >62.3 cc/m2, EAT volume was associated with high-risk plaque [univariate OR 2.50 (95%-CI:1.69-3.72), p < 0.001)], which remained significant [OR 1.83 (95%-CI:1.10-3.05), p = 0.020] after adjustment. Subjects with high-risk plaque had lower mean attenuation EAT (-88.1 vs. -86.9 HU, p = 0.008) and PAT (-106 vs. -103 HU, p < 0.001), though this was not significant in multivariable analysis. Conclusions: Greater volumes of EAT are associated with high-risk plaque independent of risk factors, CACS and obstructive CAD. This observation supports possible local influence of EAT on development of high-risk coronary plaque.
AB - Background and aims: To determine whether epicardial (EAT) and paracardial adipose tissue (PAT) volume and attenuation are associated with high-risk coronary plaque features. Methods: In subjects with suspected acute coronary syndrome (ACS) enrolled in the ROMICAT II trial, EAT and PAT volumes indexed to body surface area (BSA) and attenuation were measured on non-contrast coronary artery calcium score (CACS) CT. High-risk plaque features (napkin-ring sign, positive remodeling, low density plaque, spotty calcium) and stenosis were assessed on coronary CT angiography (CTA). The association of EAT and PAT volume and attenuation with high-risk plaque and whether this was independent of clinical risk assessment, CACS and significant coronary artery disease (CAD) was determined. Results: Of 467 (mean 54 ± 8 yrs, 53% male) with CACS and CTA, 167 (36%) had high-risk plaque features. Those with high-risk plaque had significantly higher indexed EAT (median 59 (Q1-Q3:45-75) cc/m2 vs. 49 (35-65) cc/m2, p < 0.001) and PAT volume (median:51 (36-73) cc/m2 vs. 33 (22-52) cc/m2, p < 0.001). Higher indexed EAT volume was associated with high-risk plaque [univariate OR 1.02 (95%-CI:1.01-1.03) per cc/m2 of EAT, p < 0.001], which remained significant [univariate OR 1.04 (95%-CI:1.00-1.08) per cc/m2 of EAT, p = 0.040] after adjustment for risk factors, CACS, and stenosis ≥50%. Higher indexed PAT volume was associated with high-risk plaque in univariate analysis [OR 1.02 (1.01-1.03) per cc/m2 of PAT, p < 0.001], though this was not significant in multivariate analysis. At a threshold of >62.3 cc/m2, EAT volume was associated with high-risk plaque [univariate OR 2.50 (95%-CI:1.69-3.72), p < 0.001)], which remained significant [OR 1.83 (95%-CI:1.10-3.05), p = 0.020] after adjustment. Subjects with high-risk plaque had lower mean attenuation EAT (-88.1 vs. -86.9 HU, p = 0.008) and PAT (-106 vs. -103 HU, p < 0.001), though this was not significant in multivariable analysis. Conclusions: Greater volumes of EAT are associated with high-risk plaque independent of risk factors, CACS and obstructive CAD. This observation supports possible local influence of EAT on development of high-risk coronary plaque.
KW - Coronary CT angiography
KW - Coronary atherosclerosis
KW - Epicardial adipose tissue
KW - High-risk coronary plaque
KW - Paracardial adipose tissue
UR - http://www.scopus.com/inward/record.url?scp=84973369637&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84973369637&partnerID=8YFLogxK
U2 - 10.1016/j.atherosclerosis.2016.05.033
DO - 10.1016/j.atherosclerosis.2016.05.033
M3 - Article
C2 - 27266821
AN - SCOPUS:84973369637
VL - 251
SP - 47
EP - 54
JO - Atherosclerosis
JF - Atherosclerosis
SN - 0021-9150
ER -