Assessment of pericoronary adipose tissue attenuation

We read with interest the recent study by Sagris et al.1 and congratulate the authors for the first systematic review and meta-analysis examining pericoronary adipose tissue (PCAT) and associations with major adverse cardiac events (MACE). Nonetheless, this field is perhaps more nuanced and immature than might be apparent from this study. The work from the authors is commendable, but there remain important limitations and caution must be taken with the current results. Subsequent systematic reviews might need to provide more granularity regarding potential confounding features. No new data were generated or analysed in support of this research.