Perivascular fat attenuation index and high-risk plaque features evaluated by coronary CT angiography: relationship...

Area of Science:

• Cardiovascular Imaging
• Biomarkers
• Radiology

Background:

• Coronary artery disease (CAD) poses a significant health burden.
• Inflammation plays a crucial role in CAD pathogenesis.
• High-sensitivity C-reactive protein (hs-CRP) is a known marker of inflammation.

Purpose of the Study:

• To investigate the association between perivascular fat attenuation index (FAI), high-risk plaque features, and serum hs-CRP levels in patients with intermediate pre-test probability of CAD.
• To determine if perivascular FAI can serve as a non-invasive marker for inflammation in CAD.

Main Methods:

• Coronary CT angiography (CCTA) was used to assess high-risk plaque features (low attenuation plaque, positive remodeling, napkin-ring sign, spotty calcification).
• Lesion-specific perivascular FAI was measured in major epicardial vessels.
• Serum hs-CRP levels were recorded and analyzed in relation to CCTA findings and perivascular FAI.

Main Results:

• Napkin-ring sign and low attenuation plaque were more prevalent in patients with elevated hs-CRP (p < 0.05).
• No significant differences in other plaque features (lesion length, positive remodeling, spotty calcification) were observed between hs-CRP groups.
• Perivascular FAI showed no significant difference between elevated and normal hs-CRP groups (p = 0.953) and a poor correlation with hs-CRP (r = -0.04, p = 0.510).

Conclusions:

• Elevated hs-CRP in CAD patients is associated with specific high-risk plaque features like napkin-ring sign and low attenuation plaque.
• Perivascular FAI does not appear to be a reliable imaging biomarker for systemic inflammation (hs-CRP) in this patient cohort.