Table 3.
List of studies reporting the role of PCATMA in prognostication and risk stratification
| First author | Year | Study type | Measurement method | Patients | Main findings | |
|---|---|---|---|---|---|---|
| Ichikawa 76 | 2022 | Prospective cohort study | Patient based (proximal 10–50 mm of RCA and proximal 40 mm of LAD) | 333 patients with Type 2 diabetes mellitus undergoing clinically indicated CCTA | LAD PCATMA > −70.7 HU can significantly predict cardiovascular events in T2DM patients. | |
| Goeller 77 | 2021 | Prospective cohort study | Patient based (proximal 10–50 mm of RCA) | 293 patients who underwent CCTA because of atypical chest pain and blood sample to analyze serum levels of atherosclerosis-relevant inflammatory mediators | RCA PCATMA ≥ −73.5 HU is an independent predictor of MACE and shows a weak association with serum levels of atherosclerosis-relevant inflammatory biomarkers. | |
| Hirano 78 | 2021 | Prospective cohort study | Patient-based (40 mm segments of the 3 coronary vessels, RCA starting 10 mm distal to the ostium, LAD and LCX starting at LM bifurcation) | 114 CAD patients who underwent CCTA and invasive angiography and invasive functional measurements showing intermediate or severe stenosis |
PCATMA is independently and significantly associated with LV mass index in patients with functionally significant epicardial stenosis and preserved systolic function. | |
| Hoshino 79 | 2021 | Retrospective cohort study | Patient-based (proximal 40 mm of LAD) | 220 consecutive patients with intermediate stenosis who underwent CCTA within 90 days of FFR | Patients with LADPCATMA ≥ −73.1 HU have an increased risk of MACE. | |
| Kanaji 34 | 2021 | Retrospective cohort study | Vessel-based (40 mm segments of the three coronary vessels, RCA starting 10 mm distal to the ostium, LAD and LCX starting at LM bifurcation) | 131 patients who underwent CCTA for suspected CAD, showing an intermediate-severe coronary stenosis, followed by phase-contrast MRI prior to PCI within 60 days | PCATMA is significantly associated with CFR independently of epicardial stenosis severity evaluated by FFR in CAD patients with a single lesion and preserved systolic function. | |
| Oikonomou 80 | 2021 | Software training and validation | Patient-based (40 mm segments of the 3 coronary vessels, RCA starting 10 mm distal to the ostium, LAD and LCX starting at LM bifurcation) | 3912 consecutive patients undergoing CCTA as part of clinical care in the USA (n = 2040, training cohort) and Europe (n = 1872, validation cohort). | CT cloud-based quantitative software that calculates PCATMA and, together with traditional cardiovascular risk factors and information extracted from plaque analysis, gives a vessel-specific coronary inflammation score which correlated with the risk for a fatal cardiac event in the next 8 years. | |
| Kanaji 36 | 2020 | Retrospective cohort study | Patient-based (average PCATMA of LAD, LCX and RCA, 40 mm segments of the 3 coronary vessels, RCA starting 10 mm distal to the ostium, LAD and LCX starting at LM bifurcation) | 116 patients with suspected first NSTEMI who underwent CCTA and subsequent successful PCI and CMR | Measured PCATMA before urgent percutaneous coronary intervention (PCI) was significantly related to lower CFR acquired with magnetic resonance at one-month post‐PCI | |
| Oikonomou 81 | 2018 | Retrospective multicohort study | Patient-based (40 mm segments of the 3 coronary vessels, RCA starting 10 mm distal to the ostium, LAD and LCX starting at LM bifurcation). Statistical analysis performed only with RCA PCATMA. | 3912 consecutive patients who underwent clinically indicated CCTA in two different institutes. 1872 patients in the first cohort (derivation cohort), 2040 patients in the second cohort (validation cohort). | RCA PCATMA ≥ -70.1 HU predicts all-cause and cardiac mortality beyond current risk stratification approaches, including measurement of coronary calcium and CCTA evaluation. | |
PCATMA: pericoronary adipose tissue mean attenuation; LAD: left anterior descending artery; LCX: left circumflex artery; RCA: right coronary artery; CCTA: Coronary Computed Tomography Angiography; FFR: Fractional Flow Reserve; CAD: coronary artery disease; MI: Myocardial Infarction; ACS: Acute Coronary Syndrome; CMR: Cardiac Magnetic Resonance; PCI: Percutaneous Coronary Intervention;CFR: Coronary Flow Reserve; MACE:Major Adverse Cardiovascular Events