Abstract 17634: Increase in Epicardial Fat Volume is Associated with Greater Coronary Artery Calcification Progression in Subjects at Intermediate Risk by Coronary Calcium Score: A Serial Study Using Non-Contrast Cardiac CT
Objective: Epicardial fat volume (EFV) is related to calcified coronary plaques. However, it is unknown whether baseline EFV or changes in EFV affect the progression of coronary artery calcification over time.
Methods: We identified 375 consecutive asymptomatic subjects with an intermediate risk of developing coronary heart disease [1) a man ≥55 years or woman ≥65 years or 2) a man 45-54 years or woman 55-64 years with at least 1 traditional CAD risk factor and baseline coronary calcium score (CCS) 50-399] who underwent serial non-contrast CT at least 3-5 years apart. Subjects were divided into tertiles of CCS progression (% increase) between the 2 scans. Subjects from the upper tertile (High Progressors) were matched by age and gender to 81 subjects from the lower tertile (Low Progressors). All subjects underwent serial measurements of CCS and EFV. The relationship between EFV and CCS progression, and changes in plaque number were compared between the two groups.
Results: At baseline, there was no difference in EFV, and EFV indexed to body surface area (EFVi) between the two groups. At follow-up, EFV, EFVi and percent increase in EFVi-change were higher in the High Progressors than the Low Progressors (EFV, 102 ± 38 cm3 vs. 90 ± 35 cm3, p=0.03; EFVi, 50 ± 16 cm3/m2 vs. 45 ± 15 cm3/m2, p=0.03; EFVi-change, 15 ± 22% vs. 7 ± 20%, p=0.02). Based on our previously determined inter-scanner and inter-observer variability, a ≥ 15 % increase from baseline EFVi was set as the criterion for significant EFVi increase. On multivariate analysis, after adjusting for conventional cardiovascular risk factors, EFVi increase ≥ 15% and scan interval time were predictive of being a High Progressor [EFVi increase ≥ 15%, p<0.05, OR 2.3, 95% C.I 1.0-5.3, scan interval time p=0.003, OR 1.0, 95% CI 1.001-1.006]. By multivariable linear regression analysis, EFVi increase ≥ 15% (β= 3.0, 95% C.I. 0.4 - 5.6, p=0.02) and hypertension (β= 3.1, 95% C.I. 0.6 - 5.6, p=0.01) were independent predictors of the number of new calcified plaques on follow-up.
Conclusion: Increase in EFV is associated with greater progression of coronary artery calcification in intermediate-risk subjects.
- © 2011 by American Heart Association, Inc.