Evidence map›Paper›PMID 27266821›Full record

Trial reportAtherosclerosis2016

Epicardial and paracardial adipose tissue volume and attenuation - Association with high-risk coronary plaque on computed tomographic angiography in the ROMICAT II trial.

Michael T Lu, Jakob Park, Khristine Ghemigian, Thomas Mayrhofer, Stefan B Puchner, Ting Liu, Jerome L Fleg, James E Udelson, Quynh A Truong, Maros Ferencik and 1 more

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Atherosclerosis, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
58citing papers in PubMed, 1 pooled it
7.0field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

58 citing papers in PubMed, 1 synthesis or guideline pooled it, 100 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 7 institutions in 4 countries.

Michael T LuCardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. Electronic address: mlu@mgh.harvard.edu.
Jakob ParkCardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; University of Heidelberg, Heidelberg, Germany.
Khristine GhemigianCardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Thomas MayrhoferCardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; School of Business Studies, Stralsund University of Applied Sciences, Stralsund, Germany.
Stefan B PuchnerDivision of Cardiovascular and Interventional Radiology, Vienna University Hospital, Vienna, Austria.
Ting LiuFirst Affiliated Hospital of China Medical University, Shenyang, China.
Jerome L FlegDivision of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD, USA.
James E UdelsonDivision of Cardiology and the Cardio-Vascular Center, Tufts Medical Center, Boston, MA, USA.
Quynh A TruongWeill Cornell Medical College, New York City, NY, USA.
Maros FerencikCardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Oregon Health & Science University, Portland, OR, USA.
Udo HoffmannCardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Harvard University · USMassachusetts General Hospital · USChina Medical University · CNCornell University · USNational Heart Lung and Blood Institute · USTufts Medical Center · USVienna General Hospital · AT

Funding

ROMICAT II - CCC - Lead ApplicationU01HL092040 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI HOFFMANN, UDO · 2009 to 2013
$4.9M
Cardiac MR and CT ResearchT32HL076136 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI NEILAN, TOMAS G · 2004 to 2019
$4.9M
Cardiovascular Imaging in Ischemic Heart DiseaseK24HL113128 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI HOFFMANN, UDO · 2012 to 2020
$1.1M
NHLBI NIH HHS K24 HL113128NHLBI NIH HHS T32 HL076136NHLBI NIH HHS U01 HL092040
6 · The paper itself

Abstract

BACKGROUND AND

aimsTo determine whether epicardial (EAT) and paracardial adipose tissue (PAT) volume and attenuation are associated with high-risk coronary plaque features.

methodsIn subjects with suspected acute coronary syndrome (ACS) enrolled in the ROMICAT II trial, EAT and PAT volumes indexed to body surface area (BSA) and attenuation were measured on non-contrast coronary artery calcium score (CACS) CT. High-risk plaque features (napkin-ring sign, positive remodeling, low density plaque, spotty calcium) and stenosis were assessed on coronary CT angiography (CTA). The association of EAT and PAT volume and attenuation with high-risk plaque and whether this was independent of clinical risk assessment, CACS and significant coronary artery disease (CAD) was determined.

resultsOf 467 (mean 54 ± 8 yrs, 53% male) with CACS and CTA, 167 (36%) had high-risk plaque features. Those with high-risk plaque had significantly higher indexed EAT (median 59 (Q1-Q3:45-75) cc/m(2) vs. 49 (35-65) cc/m(2), p < 0.001) and PAT volume (median:51 (36-73) cc/m(2) vs. 33 (22-52) cc/m(2), p < 0.001). Higher indexed EAT volume was associated with high-risk plaque [univariate OR 1.02 (95%-CI:1.01-1.03) per cc/m(2) of EAT, p < 0.001], which remained significant [univariate OR 1.04 (95%-CI:1.00-1.08) per cc/m(2) of EAT, p = 0.040] after adjustment for risk factors, CACS, and stenosis ≥50%. Higher indexed PAT volume was associated with high-risk plaque in univariate analysis [OR 1.02 (1.01-1.03) per cc/m(2) of PAT, p < 0.001], though this was not significant in multivariate analysis. At a threshold of >62.3 cc/m(2), EAT volume was associated with high-risk plaque [univariate OR 2.50 (95%-CI:1.69-3.72), p < 0.001)], which remained significant [OR 1.83 (95%-CI:1.10-3.05), p = 0.020] after adjustment. Subjects with high-risk plaque had lower mean attenuation EAT (-88.1 vs. -86.9 HU, p = 0.008) and PAT (-106 vs. -103 HU, p < 0.001), though this was not significant in multivariable analysis.

conclusionsGreater volumes of EAT are associated with high-risk plaque independent of risk factors, CACS and obstructive CAD. This observation supports possible local influence of EAT on development of high-risk coronary plaque.

Indexed as

Coronary AngiographyTomography, X-Ray ComputedAdipose TissueAgedCohort StudiesConstriction, PathologicCoronary Artery DiseaseCoronary StenosisFemaleHumansMaleMiddle AgedMultivariate AnalysisPericardiumPlaque, AtheroscleroticReproducibility of ResultsCoronary atherosclerosisCoronary CT angiographyEpicardial adipose tissueHigh-risk coronary plaqueParacardial adipose tissue

Identifiers

PMID27266821
PMCPMC4983201
OpenAlexW2404822232

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.