Prognostic value of pericoronary adipose tissue and coronary vascular function by cardiac 82Rb PET/CT imaging in patients with suspected coronary artery disease and normal myocardial perfusion imaging

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Pericoronary adipose tissue, due to its proximity coronary arteries, has been proposed contribute the progression atherosclerosis. Purpose The aim this study was evaluate prognostic value pericoronary fat thickness (PCFT), artery calcium (CAC) score and myocardial perfusion reserve (MPR) by hybrid 82Rubidium (82Rb) PET/CT imaging in patients with suspected disease (CAD) normal (MPI). Methods A total 640 without overt CAD rest-stress 82Rb MPI were studied. PCFT calculated on CT images as maximum (mm) between heart surface visceral epicardium surrounding main arteries. CAC categorized 0, <400 or ?400. MPR considered reduced when <2. Endpoints events cardiac death, nonfatal infarction revascularization. Results During a follow-up 42 ± 13 months, 29 occurred (cumulative event rate 5%). Patients older (66 vs. 60 years, p < 0.01), had higher (13 2 vs 11 mm, 0.001), prevalence ?400 (48% 21%, lower (2.1 0.7 2.7 0.7, 0.001) compared those without. <2 observed 18, (12 1 0.01). 11.2 mm best trade-off sensitivity specificity detect MPR. Event above threshold below (8% 1.5%, 0.001). At Cox univariate analysis, age (p 0.05), >11.2 predictors events. multivariate only independent (both incremental adding model including clinical data increased global chi-square from 26 35 Classification tree analysis produced 3 terminal groups. For <2, no further split needed (event 12% 3%, On contrary, ?2 stratified 7% 0.3% >11.2. Conclusions In stress MPI, vascular dysfunction high are associated risk. could help identifying at risk Combined evaluation anatomical functional abnormalities might allow better stratification.