Coronary disease & ACSResearch article
Prognostic value of pericoronary adipose tissue on electrocardiogram (ECG)-gated non-contrast computed tomography (CT) in patients with stable chest pain: insights from the PROMISE trial
- Cox proportional hazards models
- mixed-effects logistic regression
- PROMISE CT arm
Authors' conclusion
PCAT metrics, measured on ECG-gated non-contrast CT, are independently associated with adverse CAD features and MACE and provide incremental prognostic value beyond clinical risk factors and obstructive CAD.
Study context
- Population
- Patients with stable chest pain in the PROMISE CT arm, with pericoronary adipose tissue (PCAT) quantified on non-contrast, ECG-gated CT51% female, mean age 61 ± 8 years
- Participants
- 3,799 patients
- Comparison
- PCAT attenuation and body surface area-indexed PCAT volume, included simultaneously in all models, against coronary artery disease (CAD) characteristics and major adverse cardiovascular events (MACE)
Main finding
As reported in the abstract
PCAT attenuation and volume (descriptive)
PCAT attenuation
−81.4 ± 6.4 Hounsfield units (HU)
PCAT volume
12.9 ± 3.1 cm3/m²
Further findings
MACE among participants without coronary plaque (exploratory)
| Comparison | aHR (95% CI) | P value | |
|---|---|---|---|
| higher PCAT attenuation · exploratory analysis | 1.21 (1.05–1.39) | P = 0.007 | |
| 0.512Adjusted hazard ratio (log scale) |
Stenosis ≥50% and high-risk plaque
- attenuation adjusted odds ratios (per 1 Hounsfield units (HU))
- 1.02-1.03
- volume adjusted odds ratios (per 1 cm3/m²)
- 1.42-1.47
- P
- all P ≤ 0.04
- Higher (less negative) PCAT attenuation and higher PCAT volume were independently associated
MACE (all-cause death or nonfatal myocardial infarction)
- adjusted hazard ratios [aHR]
- 1.09-1.15
- P
- all P ≤ 0.02
- additional adjustment for obstructive CAD
MACE discrimination beyond atherosclerotic cardiovascular disease (ASCVD) risk score, body mass index, and obstructive CAD
- area under the curve
- 0.70-0.72
- P
- P = 0.03
Original publication
Prognostic value of pericoronary adipose tissue on ECG-gated non-contrast CT in patients with stable chest pain: insights from the PROMISE trial. Eur Heart J Cardiovasc Imaging. Published 19 August 2026. doi:10.1093/ehjci/jeag222
Summarised from the published abstract; every number is checked against it