Abstract: Objective To investigate the relationship between pericoronary adipose tissue(PCAT)-related parameters and coronary plaque stability in the elderly patients with coronary heart disease (CHD). Methods A total of 135 elderly patients with CHD admitted to Suining Central Hospital from January 2021 to December 2022 were enrolled in this study. All patients received CT angiography (CTA) detection. According to the CTA results, the patients were divided into stable group (with stable plaque) and unstable group (with unstable plaque). The general data, PCAT volume and peri-coronary fat density (FAI) of the two groups were collected and compared. Logistic regression analysis was used to analyze the influencing factors of coronary plaque instability, and the receiver operating characteristic (ROC) curve was drawn to observe the predictive value of each factor for coronary plaque instability in the elderly patients with CHD. Results A total of 30 elderly CHD patients presenting with unstable coronary artery plaque were enrolled in the unstable group (n=30), and 105 patients with stable coronary artery plaque were enrolled in the stable group (n=105). There were significant differences in PCAT volume and FAI between the two groups (P<0.01). Logistic regression analysis showed that PCAT volume and FAI were risk factors of coronary plaque stability in the elderly patients with CHD. The areas under the curve (AUC) of PCAT volume and FAI in predicting plaque instability were 0.829, 0.814, with the sensitivity of 0.867, 0.700, and the specificity of 0.686, 0.838,respectively.And the optimal threshold was 63.050 cm³ and -76.620 HU. Conclusions PCAT volume and FAI are the influencing factors of coronary plaque instability in the elderly patients with CHD, and both indexes have high predictive value for the occurrence of coronary plaque instability.

Key words: pericoronary adipose tissue, coronary heart disease, coronary plaque, stability