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. 2023 Apr 17;24(8):7398.
doi: 10.3390/ijms24087398.

Elevated FAI Index of Pericoronary Inflammation on Coronary CT Identifies Increased Risk of Coronary Plaque Vulnerability after COVID-19 Infection

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Elevated FAI Index of Pericoronary Inflammation on Coronary CT Identifies Increased Risk of Coronary Plaque Vulnerability after COVID-19 Infection

Botond Barna Mátyás et al. Int J Mol Sci. .

Abstract

Inflammation is a key factor in the development of atherosclerosis, a disease characterized by the buildup of plaque in the arteries. COVID-19 infection is known to cause systemic inflammation, but its impact on local plaque vulnerability is unclear. Our study aimed to investigate the impact of COVID-19 infection on coronary artery disease (CAD) in patients who underwent computed tomography angiography (CCTA) for chest pain in the early stages after infection, using an AI-powered solution called CaRi-Heart®. The study included 158 patients (mean age was 61.63 ± 10.14 years) with angina and low to intermediate clinical likelihood of CAD, with 75 having a previous COVID-19 infection and 83 without infection. The results showed that patients who had a previous COVID-19 infection had higher levels of pericoronary inflammation than those who did not have a COVID-19 infection, suggesting that COVID-19 may increase the risk of coronary plaque destabilization. This study highlights the potential long-term impact of COVID-19 on cardiovascular health, and the importance of monitoring and managing cardiovascular risk factors in patients recovering from COVID-19 infection. The AI-powered CaRi-Heart® technology may offer a non-invasive way to detect coronary artery inflammation and plaque instability in patients with COVID-19.

Keywords: COVID-19; chronic coronary syndrome; fat attenuation index; pericoronary adipose tissue; plaque vulnerability; thrombosis; vascular inflammation.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Conventional CCTA image of the three major coronary arteries (a) and a colored mapping representation of an abnormal FAI for the same patient (b). Figure shows CCTA images of the three major coronary arteries with a stable atherosclerotic lesion (yellow arrows) in a patient who had a COVID-19 infection a few months prior to CCTA examination (a) and delineated pericoronary fat with the FAI colored mapping around the non-culprit lesions (blue arrows) demonstrating abnormal FAI in the same patient (b). Using the CaRi-Heart® v2.4.2 platform (panel b), FAI-Score was evaluated for each individual at baseline in the proximal LAD, LCX, and RCA.
Figure 2
Figure 2
Nomograms with percentile curves for FAI-Score, adjusted for age, gender, and risk factors for each major coronary territory.
Figure 3
Figure 3
PVAT-FAI Score Centile of Coronary Inflammation for each coronary artery.

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