Abstract 139 Relationship between the fat attenuation index and plaque burden in an unselected population undergoing coronary computed tomography angiography

Clin Res Cardiol (2022). https://doi.org/10.1007/s00392-022-02087-y
Relationship between the fat attenuation index and plaque burden in an unselected population undergoing coronary computed tomography angiography
A. Giesen¹, S. Hagstotz¹, P. Nunninger², M. Schütz¹, G. Korosoglou¹, S. Giusca¹
¹Kardiologie, Angiologie und Pneumologie, GRN Klinik Weinheim, Weinheim; ²Radiologie Weinheim, Weinheim;
Background: The fat attenuation index (FAI) is a marker of inflammation of the perivascular tissue surrounding the coronary arteries. Its prognostic value in patients undergoing coronary computed tomography angiography (CCTA) is already established. Nevertheless, the relationship between FAI and plaque burden is not very well defined. Aim: We sought to evaluate the relationship between FAI and plaque burden in patients undergoing CCTA for suspected or known CAD. Methods: Consecutive patients (pts.) with a clinical indication for CCTA due to chronic coronary syndromes (CCS) were included in our study. FAI was measured in the proximal 4 cm of each of the coronary arteries (right coronary artery RCA, left anterior descending artery LAD and left circumflex artery LCX). Plaque burden was measured in the first two segments of each coronary arteries in patients who exhibited at least one stenosis in at least one segment >25%. A FAI RCA>-70.1 was previously described to carry prognostic information and was used as cut-off value. Results: 346 pts. (67±12 years) underwent CCTA between September 2020 and March 2022. No correlation was found between FAI and conventional cardiovascular risk factors. FAI was higher in patients with a calcium score >400(p<0.001 for all 3 coronary arteries, and in the presence of coronary artery stenosis>50% (p<0.05 for all 3 coronary arteries) or >70% (p<0.05 for all 3 coronary arteries). 165 pts had at least one coronary stenosis>25%. In these patients, FAI RCA, FAI LAD and FAI LCX exhibited good correlation with total plaque burden (p<0.05 for all) and with total non-calcified plaque burden (p<0.05 for all), while no correlation was found with total calcified plaque burden. The total non-calcified plaque burden was higher in patients with a FAI RCA>-70.1 (1553.7±755 mm³ vs 1246.1±752.7 mm³, p=0.01). Conclusions: The FAI exhibits good correlations with total and non-calcified plaque burden in patients undergoing CCTA for suspected or known CAD. The prognostic relevance of the combination of these two parameters needs to be further investigated.
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