Non-invasive detection of coronary inflammation using computed tomography and prediction of residual cardiovascular risk (the CRISP CT study): a post-hoc analysis of prospective outcome data
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Key result
High perivascular fat attenuation index on coronary CTA predicts ~462% greater cardiac mortality.
- HR 9.04
- HR 5.62
Why the study?
Does perivascular fat attenuation index (FAI) predict all-cause and cardiac mortality in patients undergoing coronary CTA?
Population
3,912 consecutive patients undergoing clinically indicated coronary CTA in Germany and USA.
Design
Cohort, Images were anonymised locally and transferred to a core laboratory…
Follow-up
Median 72 months in derivation cohort and 54 months in…
Authors
Discussion
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Implication
High FAI on coronary CTA may refine mortality risk stratification; leaves open incremental value and clinical adoption pending prospective trials.
Structured PICO
Does perivascular fat attenuation index (FAI) predict all-cause and cardiac mortality in patients undergoing coronary CTA?
P
Population
3,912 consecutive patients undergoing clinically indicated coronary CTA (1,872 in derivation cohort, median age 62, 63% male; 2,040 in validation cohort, median age 53, 55% male) in Germany and USA.
I
Intervention
Perivascular fat attenuation index (FAI) mapping around the proximal right coronary artery on coronary CTA
O
Outcome
All-cause mortality and cardiac mortalityhard clinical
Perivascular FAI measured on routine coronary CTA provides a quantitative measure of coronary inflammation that significantly improves cardiac risk prediction and restratification beyond current state-of-the-art assessment.
Cite This Study
Oikonomou et al. (2018) studied this question. High perivascular fat attenuation index (≥−70.1 HU) on coronary CTA significantly predicted increased cardiac mortality in derivation (HR 9.04) and validation (HR 5.62) cohorts.
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