Pericoronary adipose tissue as a biomarker of coronary atherosclerosis and cardiovascular risk in rheumatoid arthritis

Figures

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  Figure 1. Flow diagram of pericoronary adipose tissue and atherosclerosis assessments. CCTA: coronary computed tomography angiography; RA: rheumatoid arthritis

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  Figure 2. Associations of PCATa with baseline coronary plaque. (A) Adjusted incidence rate ratios and 95% CIs from negative binomial models assessing associations of standardized PCATa measures with plaque counts. (B) Adjusted standardized beta coefficients and 95% CIs from linear models assessing associations of the same PCATa measures with standardized natural log-transformed plaque volumes. All models adjusted for atherosclerotic cardiovascular disease risk score, log indexed epicardial adipose tissue volume, statin use, prednisone use, and Disease Activity Score in 28 joints with erythrocyte sedimentation rate. CI: confidence interval; LAD: left anterior descending artery; LCx: left circumflex artery; PCATa: pericoronary adipose tissue attenuation; RCA: right coronary artery; SD: standard deviation

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  Figure 3. Associations of PCATa with coronary plaque progression. (A) Adjusted incidence rate ratios and 95% CIs from negative binomial models assessing associations of standardized PCATa measures with counts of new plaques. Models adjusted for ASCVD risk score, log iEATv, statin and prednisone duration, time-averaged DAS28-ESR and baseline plaque count. (B) Adjusted standardized beta coefficients and 95% CIs from linear models assessing associations of the same PCATa measures with standardized plaque volume change, defined as the difference between natural log-transformed follow-up and baseline plaque volumes. Models adjusted for ASCVD risk score, log iEATv, statin and prednisone duration, and time-averaged DAS28-ESR. ASCVD: atherosclerotic cardiovascular disease; CI: confidence interval; DAS28-ESR: Disease Activity Score in 28 joints with erythrocyte sedimentation rate; LAD: left anterior descending artery; LCx: left circumflex artery; log iEATv: natural log-transformed indexed epicardial adipose tissue volume; PCATa: pericoronary adipose tissue attenuation; RCA: right coronary artery; SD: standard deviation

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  Figure 4. Associations of PCATa with cardiovascular event risk. Unadjusted and adjusted hazard ratios and 95% CIs from Cox models evaluating (A) standardized PCATa measures and (B) PCATa thresholds (mean >−73.2 HU, LAD >−81.9 HU, LCx >−82.9 HU, RCA >−75.4 HU). Numbers below/above PCATa threshold: mean 99/38, LAD 50/87, LCx 7/130, RCA 95/42. Adjusted models covary for atherosclerotic cardiovascular disease risk score and baseline total plaque number. Adjusted estimates are shown in corresponding forest plots. CI: confidence interval; HR: hazard ratio; LAD: left anterior descending artery; LCx: left circumflex artery; PCATa: pericoronary adipose tissue attenuation; RCA: right coronary artery; SD: standard deviation

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  Figure 5. Discriminative performance of PCATa prognostic thresholds for predicting cardiovascular events. Receiver operating characteristic curves comparing a base model (atherosclerotic cardiovascular disease risk score, baseline total plaque number; dashed black line) with models that additionally included PCATa thresholds (solid red line): (A) mean >−72.1 HU, (B) left anterior descending artery >−80.8 HU, (C) left circumflex artery >−81.8 HU, (D) right coronary artery >−74.3 HU. Group sizes reported in Fig. 4. AUC: area under the curve; PCATa: pericoronary adipose tissue attenuation