Abstract 5509: Association of Pericardial Adipose Tissue With Coronary Atherosclerotic Plaque and Inflammatory Blood Biomarkers
Background: Pericardial adipose tissue (PAT) may exert paracrine effects on the pathogenesis of coronary artery disease (CAD). Thus, we assessed the relationship of PAT and different stages of coronary atherosclerosis, and inflammatory biomarkers.
Methods: We included 355 subjects (mean age: 52±11 years, 60% male) without known CAD who had acute chest pain but no acute coronary syndrome. All subjects underwent contrast-enhanced 64-slice cardiac CT. PAT was defined by any pixel with a CT attenuation of −190 HU to −30 HU within the pericardial sac. Blood samples were collected at the time of CT scan, frozen, and subsequently analyzed for inflammatory biomarkers (E-Selectin, hs-CRP, IL-18, MCP-1, MMP-2, MMP-9, PAI-1, TNF-α). We determined the association of PAT to the presence and extent of coronary atherosclerosis, and inflammatory biomarker levels.
Results: In multivariable analyses, age, gender male, BMI, and current smoking were associated with higher levels of PAT (all p≤0.01). Moreover, the presence of any (β: 18.3 cm3, 95%-CI: 7.0 –29.6, p=0.002), non-calcified (β: 31.5 cm3, 95%-CI: 11.3–51.8, p=0.002), and mixed plaque (β: 15.6 cm3, 95%-CI: 1.7–29.5, p=0.03) was associated with increased PAT independent of age, gender, and current smoking. This association persisted even after adjustment for BMI, except for non-calcified plaque. Hs-CRP, IL-18 and PAI-1 were significantly higher in subjects with increased PAT, independent of the presence of CAD (see Table⇓; following symbols within the table indicate a significant difference (p<0.0253) for the subgroup comparison: * ‘low PAT/no plaque’ vs. ‘low PAT/yes plaque’; ° ‘high PAT/no plaque’ vs. ‘high PAT/yes plaque’; † ‘low PAT/no plaque’ vs. ‘high PAT/no plaque’; ‡ ‘low PAT/yes plaque’ vs. ‘high PAT/yes plaque’).
Conclusion: PAT is associated with plaque by CT above and beyond the effect of traditional CVD risk factors. These data may support a central role of PAT in the development of coronary atherosclerosis.