Abstract 10978: Visceral Abdominal Fat as a Marker of Accelerated Progression of Noncalcified Coronary Plaque
[Introduction] Excess visceral abdominal fat (VAT) is more strongly associated with risk factors of coronary artery disease (CAD) than body mass index (BMI) or waist circumference.
[Hypothesis] We tested the hypothesis that adding VAT measurements to CAD risk factors provides better risk assessment for CAD progression. [Methods] This prospective cohort study comprised 553 CAD patients with coronary plaque with ≤ 50% coronary stenosis as assessed by computed tomography (CT) angiography. Quantification of VAT area was performed together with CT angiography using abdominal CT scanning.
[Results] After a mean 42±8 month follow-up, 324 patients underwent repeated CT scans for worsening angina symptoms without findings of positive ischemia. Increased segments of noncalcified plaque were seen in 156 (48%) and increases above the median calcium score were seen in 166 (51%) patients. The risk for progression of noncalcified plaque increased steadily with higher VAT quartiles, independent of CAD risk factors. Patients in the higher quartiles were at increased risk of progression of noncalcified plaque (quartiles IV OR 5.4; 95% CI 2.6-11.4, p-value < 0.001). In contrast, increases above the median calcium score showed no independent correlation to VAT. Progression of noncalcified plaque showed no phased increase with either higher waist circumference or BMI quartiles.
[Conclusion] VAT accumulation was positively associated with progression of coronary noncalcified plaque, but not of calcified plaque. This suggests that risk assessment of progression of noncalcified plaque can be improved by combining VAT measurements and CAD risk factors.
- © 2012 by American Heart Association, Inc.