Epicardial adipose tissue thickness can be used to predict major adverse cardiac events

• Published in: Coronary artery disease Vol. 26; no. 8; pp. 686 - 691
• Main Authors: Tanindi, Asli, Erkan, Aycan F, Ekici, Berkay
• Format: Journal Article
• Language: English
• Published: England Copyright Wolters Kluwer Health, Inc. All rights reserved 01-12-2015
• Subjects: Adipose Tissue - diagnostic imaging; Age Factors; Aged; Angina, Stable - complications; Angina, Stable - therapy; Angina, Unstable - complications; Angina, Unstable - therapy; Cardiovascular Diseases - mortality; Coronary Angiography; Coronary Artery Disease - complications; Coronary Artery Disease - diagnostic imaging; Diabetes Mellitus - epidemiology; Echocardiography; Female; Humans; Hyperlipidemias - epidemiology; Hypertension - epidemiology; Male; Middle Aged; Multivariate Analysis; Myocardial Infarction - complications; Myocardial Infarction - therapy; Myocardial Revascularization - utilization; Organ Size; Pericardium - diagnostic imaging; Prognosis; Proportional Hazards Models; Prospective Studies; Recurrence; Severity of Illness Index; Smoking - epidemiology; Stroke Volume
• ISSN: 0954-6928; 1473-5830
• DOI: 10.1097/MCA.0000000000000296

OBJECTIVEIncrease in epicardial adipose tissue (EAT) thickness is associated with subclinical and manifest coronary artery disease. In addition, it is associated with the severity and extent of coronary atherosclerosis. We aimed to investigate whether increased EAT thickness is associated with adverse cardiovascular outcomes.
PATIENTS AND METHODSTwo hundred consecutive patients who were admitted with stable angina pectoris, unstable angina pectoris or acute myocardial infarction (MI), and had undergone coronary angiography were included and followed for revascularization, nonfatal MI, hospitalization for heart failure and cardiovascular death for 26 (5–30) months.
RESULTSThere were significantly more revascularizations, nonfatal MI and cardiovascular death in patients with an initial EAT thickness more than 7 mm (P<0.001 for all). Significant predictors of cardiovascular death were identified as an EAT thickness more than 7 mm [hazard ratio (HR) 1.9, 95% confidence interval (CI) 0.4–8.3, P=0.039] and diabetes (HR 3.42, 95% CI 0.7–17.5, P=0.014) in the multivariate Cox regression analysis. Event-free survival for cardiovascular death in the EAT up to 7 mm group was 97.9%, whereas it was 90.7% in the EAT more than 7 mm group (P=0.021). In addition, significant predictors of MI were identified as an EAT thickness more than 7 mm (HR 2.4, 95% CI 0.6–10.0, P=0.021) and diabetes (HR 3.4, 95% CI 1.0–11.2, P=0.04). Event-free survival for MI in the EAT up to 7 mm group was 96.4%, whereas it was 68.2% in the EAT more than 7 mm group (P=0.001).
CONCLUSIONIncrease in EAT thickness independently predicts adverse cardiac events including MI and cardiovascular death.