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Level of Vascular Inflammation Is Higher in Acute Coronary Syndromes Compared with Chronic Coronary Disease

Makoto Araki1, Tomoyo Sugiyama2, Akihiro Nakajima1

  • 1Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA (M.A., A.N., L.M.S., I.M., I.-K.J.).

Circulation. Cardiovascular Imaging
|November 3, 2022
PubMed

Insights

Higher pericoronary adipose tissue (PCAT) attenuation indicates coronary artery inflammation in acute coronary syndromes (ACS) patients compared to stable angina (SAP). PCAT attenuation is a key marker for vascular inflammation in ACS pathogenesis.

Area of Science:

  • Cardiology
  • Radiology
  • Inflammation Research

Background:

  • Vascular inflammation is central to acute coronary syndromes (ACS) pathogenesis.
  • Pericoronary adipose tissue (PCAT) attenuation on CT angiography signifies coronary artery inflammation.
  • PCAT attenuation may correlate with clinical presentation and plaque characteristics.

Purpose of the Study:

  • To investigate the relationship between clinical presentation (ACS vs. SAP) and coronary artery inflammation.
  • To assess coronary artery inflammation using PCAT attenuation measured by CT angiography.
  • To correlate PCAT attenuation with coronary plaque characteristics.

Main Methods:

  • Patients with ACS or stable angina pectoris (SAP) undergoing coronary CT angiography and OCT were enrolled.
  • PCAT attenuation was quantified around culprit lesions and in proximal coronary arteries.
  • PCAT findings were compared between ACS and SAP groups.

Main Results:

  • PCAT attenuation was significantly higher in ACS patients versus SAP patients at culprit plaque, culprit vessel, and pan-coronary levels.
  • Higher PCAT attenuation was independently associated with ACS presentation, alongside thin-cap fibroatheroma and macrophages.
  • These findings suggest PCAT attenuation is a marker for inflammation in ACS.

Conclusions:

  • PCAT attenuation is elevated in ACS patients, indicating increased vascular inflammation.
  • PCAT attenuation serves as a valuable imaging biomarker for identifying coronary artery inflammation in ACS.
  • Vascular inflammation, as indicated by PCAT attenuation, plays a critical role in ACS development.
Abstract

Keywords:
acute coronary syndromecomputed tomography angiographyoptical coherence tomographypericoronary adipose tissue attenuationstable angina

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