Abstract 21265: Relation of Epicardial Fat Volume Corrected With Body Surface Area to Vulnerable Coronary Plaques Assessed by Multislice Computed Tomography in Patients Without Coronary Artery Calcium
Background: Recent data demonstrated multislice computed tomography (MSCT) have suggested that epicardial adipose tissue (EAT) is related to coronary artery disease (CAD). However, it is unknown the relation between EAT and CAD in the early stage coronary atherosclerosis without calcification. The aim of this study was to investigate the influence of epicardial fat volume (EFV) on coronary atherosclerosis, especially vulnerable plaques, without calcification by MSCT according to the age-related differences.
Methods: MSCT was performed in 578 consecutive patients. Of these patients, 247 patients had zero calcium score. They were divided into elderly patients (≥65 years, n=106) and younger patients (<65 years, n=141). EFV was measured using the application of dedicated offline software. In this study, EFV corrected by body surface area (cEFV) was used for the analysis. In addition, we assessed the impact of cEFV on coronary atherosclerosis related to vulnerable plaques.
Results: Elderly patients had significantly greater cEFV (56.2 vs. 42.4 cm³/m², p<0.001), more frequency of patients with increased cEFV (>72.1 cm³/m²: mean + standard deviation, 22% vs. 6%, p<0.001), more presence of noncalcified plaques (NCPs, 53% vs. 33%, p<0.01), coronary artery stenosis (>50% luminal narrowing, 14% vs. 2%, p<0.01) and number of NCPs (1.0 vs. 0.6, p<0.01) than younger patients. In the multiple logistic regression analysis, hypertension (OR=3.2, p<0.05), diabetes (OR=7.2, p<0.001), dyslipidemia (OR=2.5, p<0.05) and increased cEFV (OR=3.6, p<0.05) were independent predictors of the presence of NCPs in elderly patients. And independent predictor of the presence of lipid rich plaques (LRPs: <50 HU) with positive remodeling (Remodeling Index >1.05) was increaseed cEFV (OR=4.7, p<0.05) in elderly patients. In younger patients, independent predictor of the presence of NCPs was diabetes (OR=6.5, p<0.001). And independent predictor of the presence of LRPs with positive remodeling was hypertension (OR=4.6, p<0.05).
Conclusions: These results suggest that measurement of EFV corrected with body surface area using MSCT is a useful marker for the presence of CAD related to acute coronary syndrome in elderly patients who have no coronary artery calcium.
- © 2010 by American Heart Association, Inc.