Abstract
BACKGROUND: In patients without coronary artery disease (CAD), few studies have evaluated the association between mean pericoronary adipose tissue attenuation (PCAT(MA)) and patient-based demographic factors, for example, age or sex. Therefore, the purpose of this study is to investigate the association between PCAT(MA) and various demographic factors in patients without CAD. METHODS: In this case-control study, the 806 patients who underwent coronary computed tomography angiography and were not diagnosed with CAD between July 2020 and July 2022 were retrospectively enrolled. Their PCAT(MA) values of the proximal right coronary artery were measured automatically. Patients without CAD were stratified according to sex, body mass index (BMI), and age, and the relationship between PCAT(MA) and different clinical characteristics was explored using Fisher's exact test or Chi-squared test and independent t-tests or Wilcoxon Mann-Whitney U tests. RESULTS: Compared to non-smoking women [-88.00 (-95.00, -81.00) HU], women who smoked [-84.00 (-94.00, -78.00) HU, P=0.037] had higher PCAT(MA) values and a positive correlation with PCAT(MA) (rs=0.101, P=0.036). Compared to non-hypertensive patients with BMI ≥24.91 kg/m(2) [-87.00 (-95.00, -81.00) HU], hypertensive patients with BMI ≥24.91 kg/m(2) [-84.00 (-92.00, -78.00) HU, P=0.004] had higher PCAT(MA) values, and a positive correlation with PCAT(MA) (rs=0.144, P=0.004). In a subgroup of patients without CAD stratified by sex, BMI, and age, PCAT(MA) values were all higher in patients with dyslipidemia (women, men, BMI ≥24.91 kg/m(2), BMI <24.91 kg/m(2), age ≥55 years, and age <55 years: -82.00, -82.00, -81.50, -82.00, -81.00 and -83.50 HU, respectively) than in those without dyslipidemia (-89.00, -89.00, -89.00, -90.00, -90.00 and -88.00 HU, respectively; all P<0.001) and showed a positive relationship (rs=0.328, 0.339, 0.342, 0.326, 0.367, and 0.298, respectively; all P<0.001). CONCLUSIONS: Higher PCAT(MA) attenuation values were observed in patients with dyslipidemia, smoking women, and hypertensive patients with BMI ≥24.91 kg/m(2), suggesting that PCAT(MA) values can be used to detect patients at high risk for future events with CAD even if they do not currently have atherosclerosis.