Epicardial Adipose Tissue CT Radiomics Improves Acute Coronary Syndrome Prediction Beyond Coronary Artery Calcium Score

Objectives: To determine if global epicardial adipose tissue (EAT) radiomics, derived from non-contrast coronary artery calcium (CAC) scans, improves acute coronary syndrome (ACS) prediction beyond traditional risk factors (TRFs) and Agatston score (AS) in individuals without angina. Methods: We retrospectively analyzed 2020 subjects without angina who underwent CAC scans from 2016 to 2019, among whom 76 patients developed acute coronary syndrome (ACS) during a follow-up period until December 20