Abstract 10987: Impact of Epicardial Adipose Tissue on Coronary Atherosclerotic Plaque of Nonculprit Lesions in Patients with Acute Coronary Syndrome: Analysis by Integrated Backscatter Intravascular Ultrasound

Abstract

Background: Epicardial fat volume (EFV) is increased in patients with acute coronary syndrome (ACS), and lipid-rich plaques have been associated with acute coronary events.

Objective: To investigate the relation between EFV and coronary characteristics in ACS patients with the use of integrated backscatter intravascular ultrasound (IB-IVUS).

Methods: A total of 113 consecutive individuals (mean age ± SD, 66.3 ± 10.7 years; 72.8% men) who underwent percutaneous coronary intervention (PCI) and IB-IVUS, including 67 ACS patients and 46 patients with stable angina pectoris (SAP), were enrolled in this study. Conventional and IB-IVUS images, obtained with a 40-MHz intravascular catheter, were subjected to 3D analysis to obtain the fibrous, lipid, and calcified plaque volumes. Possible effects of PCI on the plaque data were minimized by assessment of 10-mm vessel lengths located proximal from the culprit lesions. The percentage volumes of individual plaque components were calculated. EFV was measured by 64-slice computed tomography during hospitalization. Pearson’s correlation coefficients were calculated to assess the relation between EFV and clinical parameters.

Results: EFV did not differ significantly between the ACS and SAP groups (119 ± 44 vs. 103 ± 43 ml, respectively, p = 0.072). In ACS patients, EFV was positively correlated with total plaque volume, lipid plaque volume, and the percentage of lipid plaque (r = 0.24, 0.28, and 0.26, respectively, p < 0.05). Multiple regression analysis also revealed an independent interaction between EFV and the percentage of lipid plaque (Table). In contrast, in SAP patients, EFV was positively correlated with body mass index but was not correlated with coronary plaque characteristics.

Conclusion: EFV was associated with lipid-rich plaque of nonculprit lesions in patients with ACS, supporting the hypothesis that epicardial adipose tissue has a role in the deveropment of coronary lipid plaque in such patients.