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March 1, 2023Circulation Cardiovascular Imaging

Coronary Inflammation and Plaque Vulnerability: A Coronary Computed Tomography and Optical Coherence Tomography Study

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Key result

High peri-coronary adipose tissue attenuation was significantly associated with increased plaque vulnerability, including lipid-rich plaque (87.3% vs 77.8%; P=0.006) and plaque rupture (38.1% vs 23.9%).

Why the study?

Vascular inflammation drives atherogenesis and acute coronary syndromes, but the relationship between coronary inflammation measured by PCAT attenuation on CT angiography and OCT plaque characteristics required evaluation.

Does high peri-coronary adipose tissue attenuation on CT correlate with optical coherence tomography features of plaque vulnerability in patients with coronary artery disease?

Population

474 patients (198 ACS and 276 stable angina pectoris) undergoing preintervention CTA and OCT

Comparison

High PCAT attenuation (n=244) vs low PCAT attenuation (n=230) using a -70.1 HU threshold

Design

Observational study

Authors

HYHaruhito YukiNew Tokyo HospitalTSTomoyo SugiyamaTokyo Medical and Dental UniversityKSKeishi SuzukiHarvard University

Discussion

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Member takes

Overview

PCAT attenuation on CTA may aid identification of high-risk plaques; confirms link to OCT vulnerability features across ACS and stable CAD.

Study Design

Type

Observational (n=474)

Structured PICO

Does high peri-coronary adipose tissue attenuation on CT correlate with optical coherence tomography features of plaque vulnerability in patients with coronary artery disease?

P
Population
474 patients with acute coronary syndromes or stable angina pectoris who underwent preintervention coronary computed tomography angiography and optical coherence tomography.
E
Exposure
High peri-coronary adipose tissue (PCAT) attenuation (≥ -70.1 Hounsfield units)
C
Comparator
Low peri-coronary adipose tissue (PCAT) attenuation (< -70.1 Hounsfield units)
O
Outcome
Coronary plaque characteristics assessed by optical coherence tomography (including lipid-rich plaque, macrophage, microchannels, plaque rupture, and layered plaque)surrogate

Main Result

Absolute Event Rate: 87.3% vs 77.8%

p-value: p=0.006

High peri-coronary adipose tissue attenuation on CT is significantly associated with OCT features of plaque vulnerability, highlighting the link between vascular inflammation and plaque instability.

Cite This Study

Yuki et al. (2023) conducted an observational in Coronary artery disease (acute coronary syndromes and stable angina pectoris) (n=474). High peri-coronary adipose tissue (PCAT) attenuation (≥ -70.1 HU) vs. Low PCAT attenuation (< -70.1 HU) was evaluated on Optical coherence tomography features of plaque vulnerability (e.g., lipid-rich plaque) (p=0.006). High peri-coronary adipose tissue attenuation was significantly associated with increased plaque vulnerability, including lipid-rich plaque (87.3% vs 77.8%; P=0.006) and plaque rupture (38.1% vs 23.9%).

synapsesocial.com/papers/6a445b0291c82169f0615d8ahttps://doi.org/10.1161/circimaging.122.014959
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Peri-coronary adipose tissue attenuation and its association with plaque vulnerability and clinical outcomes in coronary artery disease using combined CCTA and OCT2025 · 7 citations
  2. 2Level of Vascular Inflammation Is Higher in Acute Coronary Syndromes Compared with Chronic Coronary Disease2022 · 30 citations
  3. 3Coronary Plaque Vulnerability and Pericoronary Adipose Tissue Inflammation: Emerging Insights from Advanced CT Imaging2026 · 9 citations
  4. 4Pericoronary fat attenuation in stenotic and vulnerable coronary artery plaques: Implications for coronary artery disease and associated conditions2025 · 3 citations
  5. 5Optical Coherence Tomography‐Defined Vulnerable Plaques and Intracoronary Thrombus in Acute Coronary Syndromes: Insights From the OPTICO‐ACS Program2026