Key result
Greater cardiovascular risk burden linked to higher PCAT attenuation and increased coronary plaque vulnerability.
Why the study?
Although CV risk factor burden correlates with plaque vulnerability and both CV risk factors and pericoronary inflammation predict adverse CV outcomes, the relationship between CV risk burden and perivascular inflammation measured by pericoronary adipose tissue attenuation had not been investigated.
Observational (n=579)
Greater cumulative cardiovascular risk factor burden is associated with increased pericoronary adipose tissue inflammation on CTA and a higher prevalence of vulnerable plaque features on OCT.
Higher CV risk burden linked to PCAT attenuation and vulnerable plaques; hypothesis-generating, should not yet change practice or risk stratification.
Background/Introduction Both cardiovascular (CV) risk factors and pericoronary inflammation predict adverse CV outcomes. Recent studies showed the correlation between CV risk factor burden and plaque vulnerability. However, the relationship between CV risk burden and perivascular inflammation measured by pericoronary adipose tissue (PCAT) attenuation has not been investigated. Purpose The aim of this study was to evaluate the relationship between CV risk burden and PCAT attenuation by computed tomography angiography (CTA), and plaque vulnerability assessed by optical coherence tomography (OCT). Methods A total of 579 patients (45.8% ACS, 18.7% women) undergoing pre-intervention CTA and OCT were included. PCAT attenuation was categorized as high or low using a predefined threshold of −70.1 Hounsfield units. CV risk burden was defined by the cumulative presence of diabetes mellitus, hypertension, smoking, and hyperlipidemia (Figure 1, Panel A). Features of plaque vulnerability included lipid-rich plaque (LRP), thin cap fibroatheroma (TCFA), macrophages, microvessels, and cholesterol crystals. Results As the CV risk burden becomes greater, PCAT attenuation progressively increased (P for trend = 0.002) (Figure 1, Panel B). When patients were stratified by CV risk burden and PCAT levels, those with ≥2 risk factors and elevated PCAT exhibited the greatest prevalence of vulnerability features (P for trend <0.001) (Figure 1, Panel C). LRP (P for trend <0.001), TCFA (P for trend = 0.028), macrophages (P for trend <0.001), and cholesterol crystals (P for trend = 0.033) increased progressively across groups. Conclusions As the number of CV risk factors increases, PCAT attenuation progressively increased. Those with ≥2 CV risk factors and elevated PCAT had the highest prevalence of vulnerable features. These findings demonstrate the relationship between CV risk factors, vascular inflammation, and plaque vulnerability.
No takes yet. Share an insight, caveat, or question.
Andreaggi et al. (2026) conducted an observational in Coronary artery disease (45.8% acute coronary syndrome) (n=579). Cumulative cardiovascular risk factor burden (diabetes mellitus, hypertension, smoking, hyperlipidemia) and elevated pericoronary adipose tissue (PCAT) attenuation vs. Lower cardiovascular risk factor burden (<2 risk factors) and low PCAT attenuation was evaluated on Pericoronary adipose tissue (PCAT) attenuation by CTA and coronary plaque vulnerability features by OCT (lipid-rich plaque, thin-cap fibroatheroma, macrophages, microvessels, cholesterol crystals) (p=<0.001 for trend). Greater CV risk burden progressively increased PCAT attenuation (P=0.002), and ≥2 risk factors with high PCAT had the highest plaque vulnerability (P<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: