Evidence mapPaperPMID 36069510Full record

SynthesisEuropean heart journal. Cardiovascular Imaging2022

Pericoronary fat attenuation index-a new imaging biomarker and its diagnostic and prognostic utility: a systematic review and meta-analysis.

Marios Sagris, Alexios S Antonopoulos, Spiridon Simantiris, Evangelos Oikonomou, Gerasimos Siasos, Konstantinos Tsioufis, Dimitris Tousoulis

Open access · hybridAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in European heart journal. Cardiovascular Imaging, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 74 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
74citing papers in PubMed, 1 pooled it
13.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

74 citing papers in PubMed, 1 synthesis or guideline pooled it, 93 citations in OpenAlex.

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  3. Pericoronary Adipose Tissue Density, Inflammation, and Subclinical Coronary Artery Disease Among People With HIV in the REPRIEVE Cohort.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023 · on this map
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14 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 2 countries.

Marios SagrisFirst Cardiology Clinic, School of Medicine, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, Vas. Sofias 114, 11527 Athens, Greece.ORCID 0000-0002-3473-1368
Alexios S AntonopoulosFirst Cardiology Clinic, School of Medicine, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, Vas. Sofias 114, 11527 Athens, Greece.ORCID 0000-0002-5151-0444
Spiridon SimantirisFirst Cardiology Clinic, School of Medicine, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, Vas. Sofias 114, 11527 Athens, Greece.
Evangelos OikonomouFirst Cardiology Clinic, School of Medicine, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, Vas. Sofias 114, 11527 Athens, Greece.ORCID 0000-0001-8079-0599
Gerasimos SiasosFirst Cardiology Clinic, School of Medicine, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, Vas. Sofias 114, 11527 Athens, Greece.ORCID 0000-0001-7601-8870
Konstantinos TsioufisFirst Cardiology Clinic, School of Medicine, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, Vas. Sofias 114, 11527 Athens, Greece.
Dimitris TousoulisFirst Cardiology Clinic, School of Medicine, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, Vas. Sofias 114, 11527 Athens, Greece.
National and Kapodistrian University of Athens · GRBrigham and Women's Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Pericoronary fat attenuation index (FAI) on coronary computed tomography angiography imaging has been proposed as a novel marker of coronary vascular inflammation with prognostic value for major cardiovascular events. To date, there is no systematic review of the published literature and no meta-analysed data of previously published results. We performed a systematic review and meta-analysis according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. We systematically explored published literature in MEDLINE (PubMed) before 20 January 2022 for studies assessing FAI in both diagnostic and prognostic clinical settings in patients with or without cardiovascular disease. The primary outcome was the mean difference in FAI attenuation between stable and unstable coronary plaques. The secondary outcome was the hazard ratio (HR) of high FAI values for future cardiovascular events. We calculated I2 to test heterogeneity. We used random-effects modelling for the meta-analyses to assess the primary and secondary outcomes. This study is registered with PROSPERO (CRD42021229491). In total, 20 studies referred in a total of 7797 patients were included in this systematic review, while nine studies were used for the meta-analysis. FAI was significantly higher in unstable compared with stable plaques with a mean difference of 4.50 Hounsfield units [95% confidence interval (CI): 1.10-7.89, I2 = 88%] among 902 patients. Higher pericoronary FAI values offered incremental prognostic value for major adverse cardiovascular events (MACEs) in studies with prospective follow-up (HR = 3.29, 95% CI: 1.88-5.76, I2 = 75%) among 6335 patients. Pericoronary FAI seems to be a promising imaging biomarker that can be used for the detection of coronary inflammation, possibly to discriminate between stable and unstable plaques, and inform on the prognosis for future MACE. Further validation of these findings and exploration of the cost-effectiveness of the method before implementation in clinical practice are needed.

Indexed as

Cardiovascular DiseasesPlaque, AtheroscleroticBiomarkersCoronary AngiographyHumansInflammationPrognosisProspective StudiesBiomarkerscomputed tomographyFAIfat attenuation indeximagingmajor adverse cardiovascular eventspreventionunstable plaques

Identifiers

PMID36069510
PMCPMC9840478
OpenAlexW4294921374

What Socratic holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.