Abstract 14322: Impact of Increased Epicardial Adipose Tissue Volume on Future Acute Coronary Syndrome in Patients with Coronary Artery Disease

Abstract

Introduction. Epicardial adipose tissue (EAT) has been reported as a source of various proinflammatory hormones and cytokines, independent of systemic obesity. This study aimed to investigate whether EAT volume and its changes after management for atherosclerotic risk factors had an impact on future acute coronary syndrome (ACS) events in patients with coronary artery disease (CAD).

Methods. This study consisted of 315 patients (220 men; age, 64±10 years) who underwent serial multidetector computed tomography (MDCT) examinations within 6 to 24 months. EAT was automatically identified using the threshold attenuation values of -30 to -250 Hounsfield units (Figure left). After first MDCT examination, all patients had individualized, optimized management for atherosclerotic risk factors. The end-point was ACS events including cardiac death, non-fatal myocardial infarction and unstable angina pectoris requiring hospitalization.

Results. During the interval between first and second MDCT examinations, EAT volume decreased in 118 (37%) patients. During follow-up of 3.4±1.2 years after second MDCT examination, ACS occurred in 18 (5.7%) patients. Cox hazard model analysis demonstrated that increase of EAT volume was a risk for future ACS events (p=0.01), independent of changes of body weight. Patients with increased EAT volume had worsen outcome as compared with those with decreased EAT volume (Figure right).

Conclusions. This MDCT study demonstrated that increased EAT volume was associated with poorer prognosis despite of individualized and optimized managements.