ISSN 2996-8215
International Journal of Cardiology | Vol. 4, No. 12, December 2013 | pp. 89–96
DOI: 10.46882/2013/IJC/000057
Original Research Article
Prevalence and Prognostic Significance of Subclinical Epicardial Adipose Tissue Accumulation in Stable Coronary Artery Disease
Yusuf Demir¹, Murat Kaya¹, Ahmet Yilmaz²
¹Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
²Division of Cardiovascular Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
Abstract:
Epicardial adipose tissue (EAT) is a metabolically active visceral fat depot surrounding the myocardium that secretes various pro-inflammatory adipokines. While excessive EAT is associated with general metabolic syndromes, its independent prognostic impact on ischemic event recurrence in patients with established coronary artery disease (CAD) remains quantified. This prospective study evaluated the prevalence of increased EAT volume measured via multidetector computed tomography (MDCT) and determined its correlation with long-term cardiovascular events. We enrolled 240 patients with angiographically documented stable CAD who underwent chest MDCT scans. EAT volume was quantified off-line using volumetric tracking software. Hyper-EAT was defined as an EAT volume greater than 125 cm³. Patients were followed over a 3-year period for major adverse cardiac events (MACE), which included cardiac death, non-fatal myocardial infarction, or unstable angina requiring hospitalization. An elevated EAT volume was identified in 92 patients (38.3%). During follow-up, MACE occurred in 38 patients (15.8%). The incidence of MACE was significantly higher in the high-EAT cohort compared to the normal-EAT group (26.1% vs. 9.5%, p = 0.001). Multivariable Cox proportional hazards analysis confirmed that an increased EAT volume was an independent predictor of recurrent MACE (hazard ratio: 2.15, 95% CI: 1.28–3.62, p = 0.003) after adjusting for age, body mass index, lipid profiles, and the baseline coronary artery calcium score. Subclinical accumulation of epicardial adipose tissue is prevalent in patients with stable coronary artery disease and serves as a powerful, independent predictor of long-term ischemic events, reflecting the clinical importance of local visceral adiposity in atheroprogression.
Keywords: Epicardial adipose tissue, Coronary artery disease, Visceral fat, Computed tomography, Inflammation, Prognosis
Received: September 15, 2013; Revised: October 28, 2013; Accepted: November 15, 2013; Published: December 19, 2013
Citation: International Journal of Cardiology, 2013, Vol. 4, No. 12, pp. 89–96, DOI: 10.46882/2013/IJC/000057