Prevention & lipidsCohort study

Peri-aortic fat to assess cardiovascular aging using an AI-driven radiomic biomarker

Eur Heart JPublished

  • Retrospective cohort study
  • multicohort
  • external validation

Authors' conclusion

Radiomic profiling of PAAT on routine chest CT yields a scalable imaging biomarker of cardiovascular aging.

Study context

Population
Adults with routine chest CT in four cohorts with different protocolstraining 4451
Exposure
Accelerated or resilient peri-aortic adipose tissue (PAAT) radiomic CV age vs normative agers
Outcome
Incident 5-point major adverse cardiovascular events (MACE):
  • MI
  • Stroke
  • Revascularization
  • HF
  • Death

Main finding

As reported in the abstract

5-point MACE
Each group vs normativeHR
Accelerated
1.51(95% CI 1.37–1.66)
Resilient
0.70(CI 0.63–0.77)
ΔAge-stratified event-free survival differed across groups
log-rank P < .001

Observational data: associations, not effects.

Further findings

Age prediction accuracy (31-feature radiomic signature)

years

Training MAE
2.2
Primary external validation MAE
2.7

ΔAge in separate higher-risk cohort

Median ΔAge
+5.4 years

Risk reclassification, cardiovascular age (CV-Age) substituted into PREVENT

Categorical NRI +0.03
P < 0.01
Continuous NRI +0.04
P < 0.05

Original publication

Peri-aortic fat to assess cardiovascular aging using an AI-driven radiomic biomarker. Eur Heart J. Published 9 July 2026. doi:10.1093/eurheartj/ehag498

Summarised from the published abstract; every number is checked against it