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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Jan 26, 2026; 18(1): 112857
Published online Jan 26, 2026. doi: 10.4330/wjc.v18.i1.112857
Published online Jan 26, 2026. doi: 10.4330/wjc.v18.i1.112857
Coronary computed tomography angiography adipose tissue attenuation in diabetic patients with myocardial ischemia and non-obstructive coronary arteries
Kai-Xiang Su, Si-Yu Jiang, Cai-Feng Pang, Fan Yang, Yu-Qing Tang, Rui Li, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Sichuan Key Laboratory of Medical Imaging, Nanchong 637000, Sichuan Province, China
Xiao-Gang Li, Department of Radiology, General Hospital of Northern Theater Command, Shenyang 110016, Liaoning Province, China
Wen-Feng He, Department of Cardiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
Co-first authors: Kai-Xiang Su and Si-Yu Jiang.
Co-corresponding authors: Wen-Feng He and Rui Li.
Author contributions: Su KX and Jiang SY wrote the main manuscript text, and they contributed equally to this manuscript and are co-first authors; Pang CF and Yang F were responsible for data acquisition and analysis; Tang YQ was responsible for creating the figures; Li XG provided the software utilized in the creation of this work; He WF and Li R reviewed the manuscript, and they contributed equally to this manuscript and are co-corresponding authors. All authors read and approved the manuscript.
Supported by Health Commission of Sichuan Province Medical Science and Technology Program, China, No. 24WXXT10; and Primary Health Development Research Center of Sichuan Province Program, No. SWFZ23-Y-36.
Institutional review board statement: The present study was conducted in accordance with the guidelines stipulated in Declaration of Helsinki and approved by the Ethics Committee of the Affiliated Hospital of North Sichuan Medical College (Approval No. 2024ER648-1).
Informed consent statement: The requirement for obtaining informed consent from the patients was waived due to the retrospective nature of the present study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rui Li, Professor, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Sichuan Key Laboratory of Medical Imaging, Maoyuan South Road, Shunqing District, Nanchong 637000, Sichuan Province, China. ddtwg_nsmc@163.com
Received: August 8, 2025
Revised: September 9, 2025
Accepted: November 25, 2025
Published online: January 26, 2026
Processing time: 160 Days and 21.5 Hours
Revised: September 9, 2025
Accepted: November 25, 2025
Published online: January 26, 2026
Processing time: 160 Days and 21.5 Hours
Core Tip
Core Tip: This study reveals significantly increased pericoronary adipose tissue attenuation (PCATa) in the proximal segments of the left anterior descending, left circumflex, and right coronary arteries in patients with type 2 diabetes mellitus, particularly those with ischemia with non-obstructive coronary arteries (INOCA). PCATa serves as an independent imaging biomarker for identifying INOCA and demonstrated superior diagnostic performance compared with conventional clinical indicators. The combination of PCATa and clinical parameters further improves diagnostic accuracy. These results highlight the potential value of coronary computed tomography angiography-derived PCATa in early risk stratification and noninvasive identification of INOCA in patients with type 2 diabetes mellitus.