Lack of Incremental Prognostic Value of Pericoronary Adipose Tissue Computed Tomography Attenuation Beyond Coronary Artery Disease Reporting and Data System for Major Adverse Cardiovascular Events in Patients With Acute Chest Pain
Authors' conclusion
Right coronary artery PCAT CT attenuation and CAD-RADS were independent predictors of MACEs. However, no incremental prognostic value of right coronary artery PCAT CT attenuation beyond CAD-RADS was detected for MACEs in patients with acute chest pain.
Study context
- Population
- Emergency patients with acute chest pain referred for coronary computed tomography (CT) angiography, 2010–2021
- Participants
- 1,313 patients
- Exposure
- Pericoronary adipose tissue (PCAT) CT attenuation vs Coronary Artery Disease Reporting and Data System (CAD-RADS) for predicting MACE
- Outcome
- MACE:
- Unstable angina requiring hospitalization
- Coronary revascularization
- Nonfatal MI
- All-cause death
- Follow-up
- Median 38 months
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
Prognostic value for MACE
| Group | C-index |
|---|---|
| CAD-RADS | 0.760 |
| PCAT CT | 0.712 |
| RCA PCAT + CAD-RADS | 0.777 |
C-index
CAD-RADS0.760
PCAT CT0.712
RCA PCAT + CAD-RADS0.777
- CAD-RADS vs PCAT CT: P = 0.036 — 0.760 vs 0.712
- RCA PCAT + CAD-RADS vs CAD-RADS: P = 0.129 — 0.777 vs 0.760; not significant
- CAD-RADS categories 2, 3, 4, 5 independent predictors of MACE (HR range, adjusted for clinical risk factors)
- 2.286-8.325; all P<0.005
- RCA PCAT CT attenuation independent predictor of MACE (HR, adjusted)
- 1.033; P=0.006
Observational data: associations, not effects.
Further findings
MACE incidence · median follow-up 38 months
- Patients with MACE
- 142 of the 1313 (10.81%)
Original publication
Lack of Incremental Prognostic Value of Pericoronary Adipose Tissue Computed Tomography Attenuation Beyond Coronary Artery Disease Reporting and Data System for Major Adverse Cardiovascular Events in Patients With Acute Chest Pain. Circ Cardiovasc Imaging. Published 29 June 2023. doi:10.
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