Key result
Patients with recent spontaneous coronary artery dissection had higher pancoronary pericoronary adipose tissue attenuation compared to those without SCAD (-80.6 vs -85.3 HU; p=0.002).
Why the study?
Inflammatory activity is a potential mechanism of spontaneous coronary artery dissection, but pericoronary adipose tissue attenuation had not been characterized in patients with recent SCAD.
Is recent spontaneous coronary artery dissection associated with increased pericoronary adipose tissue attenuation on CT angiography compared to patients without SCAD?
Case-Control (n=96)
No
Is recent spontaneous coronary artery dissection associated with increased pericoronary adipose tissue attenuation on CT angiography compared to patients without SCAD?
Absolute Event Rate: -80.6% vs -85.3%
p-value: p=0.002
Patients with recent SCAD exhibit higher pericoronary adipose tissue attenuation on CT angiography, suggesting increased pancoronary perivascular inflammation that is not restricted to the dissected vessel.
Higher PCAT in SCAD suggests perivascular inflammation; hypothesis-generating and requires prospective validation before any clinical use.
OBJECTIVE: Inflammatory activity is one of the potential mechanisms of spontaneous coronary artery dissection (SCAD). Recently, the pericoronary adipose tissue attenuation (PCAT) derived from CT angiography (CTA) has been established as a method for measuring vascular inflammation. We aimed to characterise the pancoronary and vessel-specific PCAT in patients with and without recent SCAD. METHODS: The study comprised patients with SCAD referred to a tertiary centre between 2017 and 2022 who underwent CTA and were compared with individuals with no prior SCAD. PCAT was analysed on end-diastolic CTA reconstructions along proximal 40 mm of all major coronary vessels as well as the SCAD-related vessel. We analysed 48 patients with recent SCAD (median 6.1 (IQR 3.5-14.9) months since SCAD, 95.8% female) and 48 patients in the group without SCAD. RESULTS: Pancoronary PCAT was higher in patients with SCAD compared with those without SCAD (-80.6±7.9 vs -85.3 HU±6.1, p=0.002). Vessel-specific PCAT in patients with SCAD compared with patients without SCAD was higher for both the RCA (-80.9±9.5 vs -87.1±6.9 HU, p=0.001) and the LCA (-80.3±7.8 vs -83.4±7.2 HU, p=0.04). In patients with SCAD, PCAT of the SCAD-related vessel was not significantly different from averaged PCAT of unaffected vessels (-81.2±9.2 vs -80.6±7.6, p=0.74). There was no association between PCAT and the interval from SCAD to CTA. CONCLUSIONS: Patients with recent SCAD have higher PCAT compared with patients without SCAD, suggesting an increased perivascular inflammatory activity. This association is not restricted to the dissected vessel.
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Wolny et al. (2023) conducted a case-control in Spontaneous coronary artery dissection (n=96). Recent spontaneous coronary artery dissection vs. No prior SCAD was evaluated on Pancoronary pericoronary adipose tissue attenuation (PCAT) (p=0.002). Patients with recent spontaneous coronary artery dissection had higher pancoronary pericoronary adipose tissue attenuation compared to those without SCAD (-80.6 vs -85.3 HU; p=0.002).
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