Association of Vessel-Specific Pericoronary Adipose Tissue Characteristics with Coronary Artery Stenosis and Plaque...

Pericoronary adipose tissue (PCAT) attenuation, a noninvasive imaging biomarker derived from coronary computed tomography angiography, reflects local vascular inflammation. This study aimed to investigate the associations between vessel-specific PCAT mean attenuation (PCATMA) and volume with the severity of coronary artery stenosis and plaque characteristics.

This retrospective, single-center, cross-sectional study included 370 patients with suspected or diagnosed coronary artery disease (CAD). We analyzed the differences in PCATMA and PCAT volume across varying degrees of coronary stenosis. Receiver operating characteristic curve analysis was employed to evaluate the diagnostic performance of PCATMA for identifying noncalcified plaques (NCPs) and severe stenosis, thereby determining optimal cutoff values. Multivariate logistic regression analysis was conducted to assess the independent predictive value of PCATMA for severe stenosis and the presence of NCPs.

Patients with more severe stenosis (≥75% and ≥90%) in the left circumflex artery (LCX) exhibited significantly higher LCX-PCATMA than those with milder stenosis. Vessels harboring NCPs had significantly higher PCATMA compared to those with calcified plaques (-79.3±8.8 HU vs. -85.8±8.8 HU, P < 0.001). After adjusting for cardiovascular risk factors, multivariate logistic regression analysis demonstrated that elevated vessel-specific PCATMA was an independent predictor for the presence of NCPs in the left anterior descending, LCX, and right coronary artery. Furthermore, LCX-PCATMA ≥ -71.6 HU was identified as an independent risk factor for predicting LCX stenosis ≥75% (OR = 2.465, 95% CI 1.387-4.382, P = 0.002) and ≥90% (OR = 2.821, 95% CI 1.422-5.596, P = 0.003).

Vessel-specific PCATMA is an independent predictor for the presence of NCPs across all major coronary arteries. Notably, PCATMA of the LCX is also an independent predictor of severe LCX stenosis, highlighting its potential as a localized biomarker for risk stratification in CAD.