Study on the Relationship between Pericoronary Adipose Tissue and Coronary Artery Stenosis and Plaque Characteristics

Abstract Purpose: Pericoronary adipose tissue (PCAT) attenuation is a non-invasive biomarker of coronary perivascular inflammation. This study aims to explore the relationship between pericoronary adipose tissue mean attenuation (PCATMA) and volume with the severity of coronary artery stenosis and plaque characteristics. Methods We conducted a retrospective study of 370 patients diagnosed with or suspected of coronary artery disease (CAD). We investigated differences in PCATMA and PCAT volume among different degrees of vessel stenosis. Receiver operating characteristic curve analysis was performed to assess the efficacy of PCATMA in predicting non-calcified plaques and severe vessel stenosis, determining the optimal cutoff values. Logistic regression analysis was utilized to study the impact of PCATMA on severe vessel stenosis and non-calcified plaques. Results Patients with more severe stenosis in the left circumflex artery (LCX) had higher PCATMA compared to those with milder stenosis. Vessels with non-calcified plaques exhibited higher PCATMA than those with calcified plaques (-79.3 ± 8.8 HU vs. -85.8 ± 8.8 HU, P < 0.001). Multivariate logistic regression analysis revealed that higher PCATMA specific to LAD, LCX, and RCA vessels was an independent risk factor for predicting non-calcified plaques. LCX-PCATMA ≥ -71.6 HU was an independent risk factor for predicting LCX stenosis ≥ 75% (OR = 2.465, 95% CI 1.387–4.382, P = 0.002) and ≥ 90% (OR = 2.821, 95% CI 1.422–5.596, P = 0.003). Conclusions Vessel-specific PCATMA serves as an independent predictor for the presence of non-calcified plaques, and LCX-PCATMA is an independent risk factor for predicting severe LCX stenosis.