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Noninvasive detection of perivascular inflammation by coronary computed tomography in the CRISP-CT study and its implications for residual cardiovascular risk

European Society of Cardiology: Coronary computed tomography angiography (CTA) is an established and highly sensitive non-invasive technique to detect obstructive and non-obstructive coronary artery disease (CAD). However, it has not been well-studied as a technique to detect inflammatory changes (or its impact on future coronary events) in the surrounding fatty tissue. Recently, a new index, fat attenuation index (FAI), has been developed to detect and quantify changes in perivascular fat resulting from ongoing inflammation, using clinically acquired coronary CTA. […] The perivascular FAI potentially identifies higher-risk patients who may have highly inflamed and potentially unstable atherosclerotic plaques. Routine coronary CT angiography could help potentially identify the residual inflammatory risk that is captured by the perivascular FAI. These are patients who might not get recognized early and the use of this new biomarker could potentially help institute intensive preventative strategies.

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