Table 2.
List of studies reporting the correlation of PCATMA with imaging markers of CAD severity
| First author | Year | Study type | Measurement method | Patients | Main findings |
|---|---|---|---|---|---|
| Nakajima 54 | 2022 | Retrospective cohort study | Patient-based, vessel-based (proximal 40 mm of all coronary arteries) and lesion-based | 198 patients presenting with NSTEMI who underwent CCTA prior to intervention | Plaque rupture is associated with higher PCATMA than plaque erosion both at the culprit plaque level and at the culprit vessel level. The mean PCATMA of all three coronary arteries is significantly higher in patients with plaque rupture than in plaque erosion. |
| Yan 55 | 2022 | Retrospective cohort study | Vessel-based (40 mm segments of the 3 coronary vessels, RCA starting 10 mm distal to the ostium, LAD and LCX starting at LM bifurcation) | 247 patients with suspected or known CAD who underwent CCTA (with derived FFRCT) and invasive FFR | PCATMA predicts ischemia independently of plaque characteristics. The use of a PCATMA threshold improves discrimination and reclassification abilities of CT visual stenosis assessment compared with stenosis assessment alone. The diagnostic performance of these two methods combined is comparable with FFRCT. |
| Chen 56 | 2021 | Retrospective case–control study | Lesion-based | 104 patients with chest pain and at least 1 non-calcified plaque on coronary CT divided in two groups: first group with at least one high risk plaque (44 patients), control group with non-high-risk plaques (60 patients) | PCATMA around high-risk plaques is higher compared to low-risk plaques. |
| Pasqualetto 57 | 2021 | Retrospective cohort study | Patient-based (proximal 10–50 mm of RCA and proximal 40 mm of LAD) | 202 patients with suspected ACS who underwent pharmacological dipyridamole SE and CCTA within a short interval (<3 months) | PCATMA is related to coronary microvascular dysfunction detected by pharmacological dipyridamole stress-echocardiography, in particular in patients without obstructive CAD. |
| Pergola 58 | 2021 | Retrospective case–control study | Patient-based (proximal 10–50 mm of RCA) | 38 patients divided in 3 groups based on CMR findings: myocarditis,
15
MINOCA
14
and TTS.
9
12 patients with atypical chest pain who underwent CCTA in the control group. |
PCATMA is significantly lower in healthy controls compared to patients with myocarditis, MINOCA and TTS. 8 days after acute event, there is no differences in PCATMA values between patients with MINOCA and controls. |
| Yuvaraj 35 | 2021 | Retrospective case–control study | Patient-based (proximal 10–50 mm ofRCA) and lesion-based | 41 CAD patients with HRP matched to 41 CAD patients without HRP | PCATMA value is higher in stable CAD patients with high-risk plaques compared to those without. |
| Ma 39 | 2021 | Retrospective case–control | Vessel-based (proximal 10 mm of LAD, LCX and RCA) Lesion-specific (10 mm in middle of lesion) | 165 symptomatic patients with 70 kvp CCTA (93 patients with CAD and 72 patients without CAD) | Lesion-specific PCATMA is increased in non-calcified and mixed plaque than calcified plaque, and in minimal stenosis compared to severe. |
| Goeller 59 | 2020 | Retrospective case–control study | Patient-based (proximal 10–50 mm of RCA) | 300 symptomatic patients with suspected CAD from three ethnic groups (100 in each group) | PCATMA is increased in patients with any plaque in the coronary tree compared to patients without plaque. PCATMA is correlated with total plaque volume and total plaque burden. |
| Hoshino 60 | 2020 | Retrospective cohort study | Patient-based (proximal 40 mm of LAD) | 187 patients with intermediate stenosis of the LAD who underwent CCTA and invasive FFR | PCATMA is associated with CCTA-derived lumen stenosis and plaque size and with functional ischemia as evaluated by FFR. |
| Lin 43 | 2020 | Prospective case–control study | Patient-based (proximal 10–50 mm of RCA) and lesion-based | 60 prospectively recruited patients with MI who underwent CCTA prior to invasive angiography, matched to patients with stable CAD 61 and controls with no CAD 61 | PCATMA independently distinguishes MI from stable CAD and no CAD. Patients with MI have a higher PCATMA compared with patients with stable CAD and controls. |
| Yu 38 | 2020 | Retrospective cohort study | Lesion-based | 167 patients with stable angina who underwent CCTA and invasive FFR measurement 2 weeks within | PCATMA is significantly higher for flow-limiting lesions than for non-flow-limiting lesions. PCATMA and total plaque volume provide incremental value to diameter stenosis for identifying hemodynamically significant lesions. |
| Gaibazzi 62 | 2019 | Retrospective case–control study | Patient-based and vessel-based (40 mm segments of the 3 coronary vessels, RCA starting 10 mm distal to the ostium, LAD and LCX starting at LM bifurcation) | 106 patients with MINOCA and Tako-Tsubo Syndrome, who had CCTA and cardiac MRI matched to 106 control subjects with atypical chest pain who had a negative CCTA | In MINOCA and Tako-Tsubo Syndrome, mean PCATMA demonstrates higher values compared with controls. |
| Goeller 63 | 2019 | Retrospective cohort study | Vessel-based (proximal 10–50 mm of RCA) | 111 consecutive symptomatic patients with suspected or known CAD and serial CCTA | PCATMA is related to the progression of plaque burden and helps identifying patients at increased risk of high-risk plaque progression. |
| Goeller 64 | 2018 | Retrospective case–control study | Lesion-based | 19 patients with ACS matched to 16 controls with stable CAD | PCATMA is higher around culprit lesions compared with non-culprit lesions of patients with ACS and the lesions of matched controls. |
PCATMA: pericoronary adipose tissue mean attenuation; LAD: left anterior descending artery; LCX: left circumflex artery; RCA: right coronary artery; NSTEMI: Non-ST-Elevation Myocardial Infarction; CCTA: Coronary Computed Tomography Angiography; FFR: Fractional Flow Reserve; FFRCT: Fractional Flow Reserve measured with Computed Tomography; CAD: coronary artery disease; MI: Myocardial Infarction; MINOCA: Myocardial Infarction with Non-obstructive Coronary Arteries; ACS: Acute Coronary Syndrome