Key result
High perivascular FAI linked to ~27% higher non-calcified plaque volume and less homogeneous calcification.
Why the study?
Perivascular FAI has emerged as a biomarker of vascular inflammation that could improve risk stratification in CAD, but plaque characteristics associated with high versus low pericoronary FAI needed evaluation.
Does a high perivascular fat attenuation index (FAI) on CCTA correlate with higher non-calcified plaque volume in patients with suspected or confirmed CAD?
Population
Patients with suspected or confirmed CAD undergoing coronary CTA (247 coronary lesions analyzed)
Comparison
High perivascular FAI phenotype (≥−70.1 HU) vs low FAI phenotype (<−70.1 HU)
Design
Retrospective analysis
Authors
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High FAI on CCTA flags higher-risk plaques; leaves open whether FAI-targeted therapy alters CAD progression.
Does a high perivascular fat attenuation index (FAI) on CCTA correlate with higher non-calcified plaque volume in patients with suspected or confirmed CAD?
High perivascular fat attenuation index on CCTA is significantly associated with larger non-calcified plaque volumes and less homogeneous calcification, indicating a higher-risk plaque phenotype.
Engel et al. (2026) studied this question. Coronary lesions with high perivascular fat attenuation index have significantly higher non-calcified plaque volume (111.8 vs 87.7 mm3, p<0.003) and less homogeneous calcification.
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