Pericoronary fat attenuation and its association with atherosclerosis in rheumatoid arthritis compared with controls: a cross-sectional study.

We compared mean and artery-specific pericoronary adipose tissue attenuation (PCATa) between rheumatoid arthritis (RA) patients and controls and examined whether clinical factors and coronary plaque burden were associated with PCATa similarly in both groups. We also explored differences in PCATa around plaque-free arteries between RA and controls.

This cross-sectional analysis included 147 patients with RA and 118 age-matched and sex-matched controls with complete coronary CT angiography data. PCATa and plaque counts (total, non-calcified, mixed or calcified) were assessed at a single time point. Models adjusted for age, sex, cardiovascular risk factors and epicardial adipose tissue volume.

Mean and artery-specific PCATa around right coronary (RCA) and left circumflex (LCx) arteries were higher in RA than controls (B=0.35 (95% CI 0.12 to 0.58), B=0.39 (95% CI 0.14 to 0.63) and B=0.25 (95% CI 0.03 to 0.48), respectively). Mean PCATa was higher in males than females (p<0.01). Age and dyslipidaemia influenced PCATa differently in RA versus controls (p for interaction=0.032 and 0.021). Mean and LCx-PCATa were associated with total and mixed plaque counts in RA but not in controls (p for interaction=0.040 and 0.021, respectively). Per-artery PCATa did not differ between RA and controls without atherosclerosis. Among participants with atherosclerosis, PCATa around plaque-free LCx and RCA vessels was higher in RA than controls (p<0.05).

PCATa was higher in RA than controls. Mean PCATa was higher in men and associated with coronary atherosclerosis in RA but not in controls. PCATa differences around plaque-free LCx and RCA vessels between RA and controls were observed among participants with plaque elsewhere.
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Karpouzas Karpouzas, Cosedis Enevoldsen Cosedis Enevoldsen, Rezaeian Rezaeian, Masic Masic, Budoff Budoff, Hauge Hauge, Ormseth Ormseth
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