Evidence map›Paper›PMID 29401041›Full record

ArticleRadiology2018

Perivascular Epicardial Fat Stranding at Coronary CT Angiography: A Marker of Acute Plaque Rupture and Spontaneous Coronary Artery Dissection.

Sandeep Hedgire, Vinit Baliyan, Evan J Zucker, Daniel O Bittner, Pedro V Staziaki, Richard A P Takx, Jan-Erik Scholtz, Nandini Meyersohn, Udo Hoffmann, Brian Ghoshhajra

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PubMed Full text at PMC Publisher
In one paragraph

Article in Radiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers.

0numbers the graph read from it
0cells of the map it votes in
39citing papers in PubMed
7.2field-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

39 citing papers in PubMed, 79 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

10 authors at 3 institutions in 2 countries.

Sandeep HedgireFrom the Division of Cardiovascular Imaging, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114 (S.H., V.B., N.M., U.H., B.G.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (E.J.Z.); Cardiac MR PET CT Program, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (D.O.B., P.S., J.E.S.); Department of Cardiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany (D.O.B.); and Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (R.A.P.T.).
Vinit BaliyanFrom the Division of Cardiovascular Imaging, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114 (S.H., V.B., N.M., U.H., B.G.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (E.J.Z.); Cardiac MR PET CT Program, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (D.O.B., P.S., J.E.S.); Department of Cardiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany (D.O.B.); and Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (R.A.P.T.).
Evan J ZuckerFrom the Division of Cardiovascular Imaging, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114 (S.H., V.B., N.M., U.H., B.G.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (E.J.Z.); Cardiac MR PET CT Program, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (D.O.B., P.S., J.E.S.); Department of Cardiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany (D.O.B.); and Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (R.A.P.T.).
Daniel O BittnerFrom the Division of Cardiovascular Imaging, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114 (S.H., V.B., N.M., U.H., B.G.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (E.J.Z.); Cardiac MR PET CT Program, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (D.O.B., P.S., J.E.S.); Department of Cardiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany (D.O.B.); and Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (R.A.P.T.).
Pedro V StaziakiFrom the Division of Cardiovascular Imaging, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114 (S.H., V.B., N.M., U.H., B.G.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (E.J.Z.); Cardiac MR PET CT Program, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (D.O.B., P.S., J.E.S.); Department of Cardiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany (D.O.B.); and Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (R.A.P.T.).ORCID 0000-0003-3219-3815
Richard A P TakxFrom the Division of Cardiovascular Imaging, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114 (S.H., V.B., N.M., U.H., B.G.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (E.J.Z.); Cardiac MR PET CT Program, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (D.O.B., P.S., J.E.S.); Department of Cardiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany (D.O.B.); and Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (R.A.P.T.).
Jan-Erik ScholtzFrom the Division of Cardiovascular Imaging, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114 (S.H., V.B., N.M., U.H., B.G.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (E.J.Z.); Cardiac MR PET CT Program, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (D.O.B., P.S., J.E.S.); Department of Cardiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany (D.O.B.); and Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (R.A.P.T.).
Nandini MeyersohnFrom the Division of Cardiovascular Imaging, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114 (S.H., V.B., N.M., U.H., B.G.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (E.J.Z.); Cardiac MR PET CT Program, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (D.O.B., P.S., J.E.S.); Department of Cardiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany (D.O.B.); and Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (R.A.P.T.).
Udo HoffmannFrom the Division of Cardiovascular Imaging, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114 (S.H., V.B., N.M., U.H., B.G.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (E.J.Z.); Cardiac MR PET CT Program, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (D.O.B., P.S., J.E.S.); Department of Cardiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany (D.O.B.); and Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (R.A.P.T.).
Brian GhoshhajraFrom the Division of Cardiovascular Imaging, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114 (S.H., V.B., N.M., U.H., B.G.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (E.J.Z.); Cardiac MR PET CT Program, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (D.O.B., P.S., J.E.S.); Department of Cardiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany (D.O.B.); and Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (R.A.P.T.).
Harvard University · USMassachusetts General Hospital · USUniversity Medical Center Utrecht · NL

Funding

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 HL076136
6 · The paper itself

Abstract

Purpose To evaluate the frequency and implications of perivascular fat stranding on coronary computed tomography (CT) angiograms obtained for suspected acute coronary syndrome (ACS). Materials and Methods This retrospective registry study was approved by the institutional review board. The authors reviewed the medical records and images of 1403 consecutive patients (796 men, 607 women; mean age, 52.8 years) who underwent coronary CT angiography at the emergency department from February 2012 to March 2016. Fat attenuation, length and number of circumferential quadrants of the affected segment, and attenuation values in the unaffected epicardial and subcutaneous fat were measured. "Cases" were defined as patients with perivascular fat stranding. Patients with significant stenosis but without fat stranding were considered control subjects. Baseline imaging characteristics, ACS frequency, and results of subsequent downstream testing were compared between cases and control subjects by using two-sample t, Mann-Whitney U, and Fisher tests. Results Perivascular fat stranding was seen in 11 subjects, nine with atherosclerotic lesions and two with spontaneous coronary artery dissections, with a mean fat stranding length of 19.2 mm and circumferential extent averaging 2.9 quadrants. The mean attenuation of perivascular fat stranding, normal epicardial fat, and normal subcutaneous fat was 17, -93.2, and -109.3 HU, respectively (P < .001). Significant differences (P < .05) between cases and control subjects included lower Agatston score, presence of wall motion abnormality, and initial elevation of serum troponin level. ACS frequency was 45.4% in cases and 3.8% in control subjects (P = .001). Conclusion Recognition of perivascular fat stranding may be a helpful additional predictor of culprit lesion and marker of risk for ACS in patients with significant stenosis or spontaneous coronary artery dissection.

Indexed as

Adipose TissueBiomarkersComputed Tomography AngiographyCoronary AngiographyCoronary Vessel AnomaliesCoronary VesselsFemaleHumansMaleMiddle AgedPericardiumPlaque, AtheroscleroticRegistriesRetrospective StudiesVascular DiseasesBiomarkers

Identifiers

PMID29401041
PMCPMC8382040
OpenAlexW2785535700

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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.