ASSESSMENT OF CORONARY INFLAMMATION USING PHOTON-COUNTING CT–DERIVED PERIVASCULAR FAT ATTENUATION INDEX: PILOT RESULTS IN PATIENTS WITH PSORIASIS
Tématický okruh: Primární a sekundární prevence | |
| Typ: Poster - lékařský , Číslo v programu: 47 | |
Etický kodex: Podpora výzkumu / granty: This study was supported by institutional funding from the Ministry of Defence of the Czech Republic (MO 1012). | |
| Němečková E. 1, Malý M. 1, Adla T. 2, Kojanová M. 3, Kuzko I. 1, Krása K. 1 1 Interní klinika 1. LF UK a ÚVN, Ústřední vojenská nemocnice - Vojenská fakultní nemocnice Praha, Praha, 2 Pracoviště zobrazovacích metod, Institut klinické a experimentální medicíny, Praha, 3 Dermatovenerologická klinika, Všeobecná fakultní nemocnice, Praha | |
Systemic inflammation is a key driver of atherosclerosis. The perivascular fat attenuation index (pFAI), derived from coronary CT angiography (CCTA), reflects local cytokine-driven inflammation in pericoronary adipose tissue and is associated with adverse cardiovascular outcomes. Photon-counting CT (PCCT) offers improved spatial resolution and spectral accuracy; however, validated PCCT-specific pFAI cut-offs are lacking. Psoriasis, a chronic immune-mediated inflammatory disease, represents a suitable model to study the link between systemic and coronary inflammation. This prospective pilot study included patients with psoriasis on biologic therapy, patients awaiting treatment, and healthy controls without known coronary artery disease. All participants underwent PCCT-based CCTA. pFAI was quantified in proximal segments of the coronary arteries and related to systemic inflammatory biomarkers and lipid parameters. Across all groups, pFAI showed modest inter-vessel variability with high intra-individual consistency. Associations between pFAI and inflammatory biomarkers were modest, and no significant correlation with lipid parameters was observed. The greatest variability was observed in the LCx, particularly in untreated psoriasis, indicating heterogeneous coronary inflammation. Despite normal CCTA findings, at least one coronary segment with pFAI ≥ −76 HU was present in 14% of healthy controls, 20% of biologically treated patients, and 40% of untreated psoriasis patients, suggesting a gradient of subclinical coronary inflammatory burden. PCCT-derived pFAI enables vessel-specific assessment of coronary inflammation and may detect subclinical cardiovascular risk not apparent on conventional CCTA. Patient recruitment is expected to be completed in summer 2026. An updated and expanded set of results from the full cohort will be presented. | |
