Abstract 12730: Impact of Persistent Epicardial Adipose Tissue Accumulation on Coronary Plaque Vulnerability and Future Acute Coronary Syndrome
Introduction: Epicardial adipose tissue (EAT) has been reported to be a source of inflammatory mediators. Multidetector computed tomography (MDCT) is capable of simultaneously providing assessment of coronary artery plaque characteristics as well as quantification of EAT volume. This study aimed to investigate the impact of persistent EAT accumulation on changes of coronary plaque vulnerability and consequent acute coronary events (ACS) occurrence in patients with coronary artery disease (CAD), using MDCT.
Methods: This study consisted of 315 patients with CAD who underwent serial MDCT examinations within 6 to 24 months. MDCT analysis included the presence of obstructive plaque, and vulnerable features such as positive remodeling, low attenuation plaque, and ring-like sign. Patients were classified into those with improved EAT accumulation (when EAT volume in the second MDCT was smaller that in first EAT volume), and those without improved EAT accumulation. After the second MDCT test, all patients were followed for more than 1 year, or until the occurrence of an ACS events.
Results: Of the 315 patients, EAT accumulation was improved in 118 (37%) patients. In patients with improved EAT accumulation, MDCT-derived vulnerable features of coronary artery was unchanged (Figure A). In contrast, the prevalence of vulnerable features was increased in patients without improved EAT accumulation (Figure B). 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 associated with future ACS events (p=0.04), independent of baseline EAT volume.
Conclusions: This MDCT study demonstrated that persistent EAT accumulation was associated with coronary plaque vulnerability and unfavorable ACS outcome in patients with CAD.
- © 2013 by American Heart Association, Inc.