Abstract 10453: Increased Visceral Fat Area and Lower High-Molecular-Weight Adiponectin Level Predict Non-calcified Coronary Plaque Vulnerability in the Middle-aged Men, Using Computed Tomographic Angiography
Background: Visceral fat accumulation has been a risk factor for coronary artery disease, and has decreased plasma high-molecular-weight adiponectin (HMW-AN) secreted from visceral adipose tissue. However, the relationships between visceral fat accumulation or lower plasma HMW-AN and non-calcified coronary plaque (NCP) vulnerability is unclear. We sought to investigate whether visceral fat accumulation or lower plasma HMW-AN is associated with the extent and vulnerability of NCPs as assessed by computed tomographic angiography (CTA).
Methods: We studied 147 male patients (age >50 years, mean age: 65±11 years) without established heart failure (NYHA I<) who underwent 64-slice CTA to diagnosis coronary artery disease. NCP burdens were assessed according to a 17-segment model. The vulnerable NCP was defined as if positive remodeling (remodeling index >1.05), low CT density (minimum CT density <39 HU), and adjacent spotty calcium (length 3/2 and width 2/3 of vessel diameter) were present. In addition, plain abdominal scans were performed to evaluate the visceral fat areas (VFAs), and plasma HMW-AN levels and serum high-sensitivity C-reactive protein levels were measured in all patients.
Results: Identifiable NCPs were present in 115 (78%) patients, and vulnerable NCP in 48 (33%). The mean NCP burden was 2.5±2.1 segments. The VFAs were negatively collated to the HMW-AN levels (r=-0.34, P<0.0001). After adjustment for age, traditional cardiovascular risk factors, and high-sensitivity C-reactive protein levels, VFAs were significantly associated with the extent of NCPs (β-estimate 0.22, P=0.049), and HMW-AN levels also showed a similar association (β-estimate -0.31, P=0.007). Moreover, not only increased VFAs (per 1 standard deviation: 41 cm2) but also lower HMW-AN levels (per 1 μg/ml) was an independent predictor for the presence of vulnerable NCP (VFAs: odds ratio [95% confidential interval] 1.93 [1.08 to 3.61], P=0.03; HMW-AN levels: 0.84 [0.71 to 0.96], P=0.01).
Conclusions: In the middle-aged men, both increased VFAs and lower HMW-AN levels are independently related to the extent and vulnerability of NCPs on CTA. Measurement of HMW-AN levels and VFAs has a potential role for identifying patients prone to acute coronary syndrome.
- © 2010 by American Heart Association, Inc.