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Coronary computed tomographic angiography (CCTA) is increasingly used in stable patients with chest pain to assess for obstructive epicardial coronary artery disease (CAD). However, many such patients do not have obstructive CAD (defined as stenosis ≥50% in the left main or ≥70% in any of the 3 major epicardial coronary arteries), and their treatment and prognosis is unclear.
In this longitudinal cohort study, U.K. investigators followed over 40,000 patients undergoing CCTA as part of their clinical care to investigate whether inflammation, as measured by a CCTA-derived perivascular fat attenuation index (FAI), could improve cardiovascular risk prediction. During a median follow-up of 2.7 years, patients without obstructive CAD (≈81% of the …