Abstract 15792: COVID-19 and Pericoronary Fat Attenuation Index; Is There a Link?

Introduction: Pericoronary fat attenuation index (pFAI) is a marker of coronary inflammation, a key step in atherosclerotic plaque formation. COVID-19 infection has also been shown to be associated with significant systemic inflammation. The aim of this study is to assess the impact of active COVID-19 infection on pFAI.

Methods: Cases consisted of patients with acute or subacute COVID-19 infection who underwent clinically indicated coronary computed tomography angiography (CCTA) and were matched 1:3 on clinical and cardiovascular risk factors to controls having no prior or active COVID-19 infection. pFAI was measured for all 3 major epicardial coronary vessels (LAD, LCx and RCA). Per-vessel and per-patient analysis were done. SARS-COV-2 variant was determined as the predominant variant at the time of diagnosis.

Results: We included 102 cases matched to 386 controls (64 ± 12 years, 42% men). Mean pFAI in overall cohort was higher in COVID-19 cases vs controls on both per patient (mean: -75.16 vs -77.15, p=0.024; LAD: -75.98 vs -78.65, p=0.004, LCx: -72.56 vs -74.38, p=0.047) (Figure 1a) and per-vessel (-75.17 vs -77.13, p=0.0001) analyses. Results of subgroup analysis of patients with no CAD and patients with CAD-RADS 0 showed a similar trend (Figure 1b-1c) . In univariable linear regression, there was a positive association between COVID-19 and pFAI for mean per patient (beta coefficient=1.90, 95% CI: 0.26 - 3.53, p=0.02) and per-vessel (beta coefficient=1.96, 95% CI: 0.85 - 3.07, p=0.00) analyses. The association remained significant after adjusting for age, sex, and cardiovascular risk factors.

Conclusions: There is a weak but statistically significant association between COVID-19 infection and elevated pFAI.