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Imaging biomarker can predict coronary inflammation

By Allen Cone

Aug. 28 (UPI) -- Researchers developed an imaging biomarker that measures inflammation of fatty tissue surrounding the coronary arteries and can help predict cardiac mortality.

The perivascular fat attenuation index, or FAI, is used to quantify fatty tissue formation surrounding the blood vessels, known as perivascular fat. The findings, by researchers at Cleveland Clinic, University of Oxford in England and University of Erlangen in Germany, were published in the journal Lancet and presented at the European Society of Cardiology Congress 2018 in Munich, Germany, on Tuesday.

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Coronary heart disease is the most common type of heart disease. Each year in the United States, about 610,000 die of heart disease and 735,000 have a heart attack, according to data from the Centers for Disease Control and Prevention.

"This is an exciting new technology which has the potential for providing a simple, non-invasive answer to detect patients at risk for future fatal heart attacks," co-first author Dr. Milind Desai, a Cleveland Clinic cardiologist, said in a press release. "More importantly, it highlights the incredible value of cross-continent collaboration to validate the findings in different populations."

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In the system, FAI captures coronary inflammation by mapping changes in perivascular fat on coronary computed tomography angiography, or CTA.

For the Cardiovascular Risk Prediction using Computed Tomography, or CRISP-CT, study, researchers analyzed data from patients undergoing coronary CT angiography, 1,872 patients in Germany from 2005 to 2009 and 2,040 patients at Cleveland Clinic from 2008 to 2016. The median patient age 62 in the German study and 53 years in the U.S. one.

"This new technology may prove transformative for primary and secondary prevention," said study leader Dr. Charalambos Antoniades, of University of Oxford's Division of Cardiovascular Medicine. "For the first time we have a set of biomarkers, derived from a routine test that is already used in everyday clinical practice, that measures what we call the 'residual cardiovascular risk,' currently missed by all risk scores and non-invasive tests."

He said it is vital to know who is at increased risk for a heart attack because of early intervention.

"I expect these biomarkers to become an essential part of standard CT coronary angiography reporting in the coming years," Antoniades said.

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