Detection of coronary inflammation

Abstract

By use of coronary CT angiography in two large real-life prospective cohorts from completely different populations, Evangelos K Oikonomou and colleagues1 validated the prognostic value of a non-invasive marker of coronary inflammation, the perivascular fat attenuation index.2 In this study, a fat attenuation index higher than −70·1 Hounsfield units was identified as a strong predictor of all-cause and cardiac mortality, independent of demographics, epicardial fat volume, high-risk plaque features, and the extent of atherosclerosis. Of note, these findings were confirmed by the validation cohort. By improving risk stratification of patients at low-to-intermediate risk over state-of-the-art coronary CT angiography through unpretentious post-processing, the fat attenuation index shows promise in gauging the residual coronary risk and improving the identification of vulnerable patients...