Why the study?
Does the inflammatory activity of pericoronary adipose tissue correlate with plaque composition in patients with NSTE-ACS?
Does the inflammatory activity of pericoronary adipose tissue correlate with plaque composition in patients with NSTE-ACS?
In patients with NSTE-ACS, increased inflammatory activity in pericoronary adipose tissue correlates with greater plaque burden and necrotic core size, suggesting a role in plaque vulnerability.
May signal higher-risk plaques in NSTE-ACS; leaves open causal role and need for prospective outcome trials.
BACKGROUND: The extravascular expression of inflammatory mediators may adversely influence coronary lesion formation and plaque stability through outside-to-inside signalling. It has been shown that the maximal standardised uptake value (SUV) of 18-fluorodeoxyglucose detected by positron emission tomography (PET/CT) is proportional to macrophage density. AIM: To investigate whether the inflammatory activity of pericoronary adipose tissue (PVAT) may influence plaque composition in acute coronary syndrome without persistent ST-segment elevation (NSTE-ACS) patients. METHODS: In a prospective study, 36 coronary arteries (LM, RCA, LCX, LAD) were investigated in non-diabetic patients with a low or intermediate risk of NSTE-ACS (GRACE ≤ 140). SUV was measured in fat surrounding coronary arteries on the sections corresponding to proximal and medial segments (Siemens biograph 64-PET/CT system). Additionally, SUV was measured in subcutaneous fat (SC), visceral thoracic fat (VS), and epicardial fat over the right ventricle (EPI). Virtual histology intravascular ultrasound (VH-IVUS) was performed to assess plaque composition (Volcano, USA). PET/CT sections were further examined in segments corresponding to coronary plaques. RESULTS: PVAT SUV in NSTE-ACS patients was significantly greater than in other fat locations (LM SUV: 1.60; RCA SUV: 1.54; LCX SUV: 1.94; LAD SUV: 2.37 vs. SC SUV: 0.57; VS SUV: 0.77; EPI SUV: 0.98; p < 0.001; ANOVA). PVAT SUV positively correlated with plaque burden (r = 0.49, p < 0.05) and necrotic core plaque rate (r = 0.68, p < 0.05), and negatively correlated with fibrous plaque rate (r = -0.52, p < 0.05). CONCLUSIONS: The inflammatory activity of PVAT reflected by SUV is greater than in subcutaneous, visceral thoracic, or epicardial tissue in NSTE-ACS patients; PVAT SUV correlates with the plaque burden and necrotic core component of coronary plaque.
No takes yet. Share an insight, caveat, or question.
Mazurek et al. (2013) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: