Serial Change of Perivascular Fat Attenuation Index in a Case of Spontaneous Coronary Artery Dissection Involving the Proximal Left Coronary Artery

The perivascular fat attenuation index (FAI) has been recognized as a cardiac computed tomography-based (CCT)-based biomarker of coronary inflammation. We report the case of a 47-year-old woman with acute spontaneous coronary artery dissection (SCAD) involving the proximal left coronary artery (LCA), who underwent FAI three times. The initial CCT scan revealed higher perivascular FAI values in the dissected LCA. The second CCT scan, performed 8 days later, showed persistence of a higher perivascular FAI value only in the left circumflex coronary artery, in which progression of stenotic severity and myocardial infarction formation were found. The persistence of a higher perivascular FAI may indicate disease deterioration in patients with SCAD.