Pericoronary adipose tissue attenuation on coronary computed tomography angiography associates with male sex and Indigenous Australian status

To evaluate if Indigenous Australians have higher coronary inflammation demonstrated non-invasively using pericoronary adipose tissue attenuation on coronary computed tomography angiography (CCTA). We retrospectively obtained a cohort 54 Indigenous patients age- and sex-matched to 54 non-Indigenous controls (age: 46.5 +/- 13.1 years; male: n=66) undergoing CCTA at the Royal Darwin Hospital and Monash Medical Centre. Patient groups were defined to investigate the interaction of ethnicity and sex: Indigenous+male, Indigenous+female, control+male, control+female. Semi-automated software was used to assess pericoronary adipose tissue attenuation (PCAT-a) and volume (PCAT-v). Males had significantly higher PCAT-a (- 86.7 +/- 7.8 HU vs. - 91.3 +/- 7.1 HU, p=0.003) than females. Indigenous patients had significantly higher PCAT-v (1.5 +/- 0.5cm(3) vs. 1.3 +/- 0.4cm(3), p=0.032), but only numerically higher PCAT-a (p=0.133) than controls. There was a significant difference in PCAT-a and PCAT-v across groups defined by Indigenous status and sex (p=0.010 and p=0.030, respectively). Among patients with matching CCTA contrast density, multivariable linear regression analysis showed an independent association between Indigenous status and PCAT-a. Indigenous men have increased PCAT-a in an age- and sex-matched cohort. Male sex is strongly associated with increased PCAT-a. Coronary inflammation may contribute to adverse cardiovascular outcomes in Indigenous Australians, but larger studies are required to validate these findings.

Automated summary

This study aimed to evaluate the association between Indigenous Australians and higher coronary inflammation using pericoronary adipose tissue attenuation. The results showed that Indigenous men had increased pericoronary adipose tissue attenuation, suggesting a potential link to coronary inflammation. Larger studies are needed to confirm these findings.