Detection of Coronary Inflammation Using CT
A 55-year-old man with a history of hypertension, hyperlipidemia, smoking, and gastroesophageal reflux disease (GERD) presents to the office with a 1-month history of intermittent epigastric discomfort associated with climbing stairs at work. The symptoms resolve with rest and are unlike his prior episodes of GERD. He takes hydrochlorothiazide 25 mg once daily, amlodipine 5 mg once daily, atorvastatin 40 mg once daily, and pantoprazole 40 mg once daily. The patient has a 30-pack-year history of smoking as well as a paternal history of coronary artery disease and cardiomyopathy.
On examination, his heart rate is 78 bpm, his blood pressure is 126/80 mmHg, and the rest of his vital signs are normal. His electrocardiogram is normal. He undergoes transthoracic echocardiography that shows normal regional wall motion and ejection fraction of the left ventricle. A coronary computed tomography angiogram (CCTA) demonstrates a non-calcified plaque in the proximal right coronary artery (RCA) interpreted as 25-49% stenosis, a calcified plaque in the left circumflex artery (LCX) interpreted as 25-49% stenosis, and no plaque in the left anterior descending artery (LAD). The patient is concerned about his risk factors and asks you if further analysis can be done to guide medical decision-making. You consider perivascular fat attenuation index (FAI) as an option.
Which of the following statements about perivascular FAI of CCTA is true?