Author + information
- Naeema Ginwala-Hasan,
- Francis Joshi,
- Jason Tarkin,
- Samantha Sartori,
- Mario Garcia,
- Usman Baber,
- Roxana Mehran,
- Pieter Muntendam,
- Valentin Fuster,
- Zahi Fayad and
- James Rudd
Background: Pericardial adipose tissue (PAT) is thought to influence the development and stability of nearby coronary atherosclerosis through paracrine inflammatory mechanisms. We tested the hypothesis that cardiac CT angiography (CCTA)-derived PAT volume (PATv) might be associated with (i) clinical CAD risk factors, (ii) cardiovascular risk scores, or (iii) high-risk CT coronary plaque morphology.
Methods: The BioImage Study enrolled 5,808 asymptomatic adults (mean age: 69 years, 56.5% female) in a prospective study evaluating vascular imaging for risk prediction. In this sub study, 374 participants underwent CCTA. PATv was derived from CT images by applying −30HU to −250HU as the threshold for adipose tissue. PATv was log-transformed to normalize the data
Results: PATv was significantly higher in patients aged ≥65 yrs (mean log PATv, 4.59 ±0.51 vs. 4.42 ±0.58 cm3, p<0.01), in men (4.66 ±0.52 vs. 4.38 ±0.52 cm3, p<0.001), and in those with raised total cholesterol ≥200 mg/dL (4.63 ±0.49 vs. 4.44 ±0.57 cm3, p< 0.001), elevated triglycerides ≥150 mg/dL (4.63 ±0.50 vs. 4.48 ±0.55 cm3, p=0.0074), and HDL <40mg/dL (4.77 ±0.42 v 4.50 ±0.55 cm3, p<0.001). In contrast, increased PATv was not observed in patients with hypertension, smokers, raised glucose levels >115 mg/dL, coronary calcium score >75% (adjusted for age and gender) or increased carotid intima medial thickness. PATv was, however, greater in patients with Framingham risk score >20% (4.69cm3 ±0.42 v 4.52cm3 ±0.55, p<0.05), modified Duke score (for CAD stenosis) >3 (4.76cm3 ±0.44 v 4.50cm3 ±0.54, p<0.001), and in patients with coronary plaques demonstrating ≥ 1 high-risk feature (positive remodeling, non-calcified plaque, high-grade stenosis, and/or low plaque attenuation; 4.59 ± 0.50 vs. 4.32 ± 0.56cm3, p<0.001) than those without.
Conclusions: In this large, prospective study, increased PATv was associated with clinical CAD risk factors and high-risk plaque phenotypes. Adding PATv to traditional CCTA reads may aid in the diagnosis of high-risk CAD. Further studies to evaluate the correlation of PATv and clinical events are warranted.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Non Invasive Imaging: Prognostic Implications of CT Angiography
Abstract Category: 27. Non Invasive Imaging: CT/Multimodality, Angiography, and Non-CT Angiography
Presentation Number: 1247-241
- 2017 American College of Cardiology Foundation