Abstract
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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 47-54 |
| Number of pages | 8 |
| Journal | Atherosclerosis |
| Volume | 251 |
| DOIs | |
| State | Published - Aug 1 2016 |
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Keywords
- Coronary atherosclerosis
- Coronary CT angiography
- Epicardial adipose tissue
- High-risk coronary plaque
- Paracardial adipose tissue
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Epicardial and paracardial adipose tissue volume and attenuation - Association with high-risk coronary plaque on computed tomographic angiography in the ROMICAT II trial. / Lu, Michael T.; Park, Jakob; Ghemigian, Khristine; Mayrhofer, Thomas; Puchner, Stefan B.; Liu, Ting; Fleg, Jerome L.; Udelson, James E.; Truong, Quynh A.; Ferencik, Maros; Hoffmann, Udo.
In: Atherosclerosis, Vol. 251, 01.08.2016, p. 47-54.Research output: Contribution to journal › Article
}
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
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 atherosclerosis
KW - Coronary CT angiography
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 -