Abstract 13546: Persistent Epicardial Adipose Tissue Accumulation Contributes Coronary Plaque Vulnerability and Future Acute Coronary Syndrome in Non-obese, Coronary Artery Disease Patients
Introduction: Epicardial adipose tissue (EAT) is recognized as a novel risk factor for coronary artery disease (CAD) and its contribution is thought to be stronger in non-obese patients than in obese patients. However, the impact of changes in EAT accumulation on CAD prognosis remains unclear. This study aimed to investigate whether an increase of EAT volume predicts future acute coronary syndrome (ACS) events in non-obese CAD patients.
Methods: This study consisted of 517 non-obese CAD patients who underwent serial multidetector computed tomography (MDCT) examinations to evaluate coronary atherosclerosis progression. All patients received comprehensive management to reduce CAD risk factors after the first MDCT examination. MDCT was repeated at 6-24 months and patients were followed-up for more than 1 year or until ACS events occurred.
Results: Of 517 patients, EAT volume increased >10ml from first to second MDCT examination in 159 (31%) patients, decreased >10 ml in 91 (18%). In remaining 267 (51%) patients, changes in EAT volume was less than 10 ml (constant group). The prevalence of obstructive plaque and MDCT-derived vulnerable features of coronary plaques were significantly elevated in patients with increase of EAT volume. In contrast, no significant changes were observed in other 2 groups. During the follow-up period of 4.1±1.8 years after the second MDCT examination, ACS occurred in 43 (8.3%) patients. Kaplan-Meier curve analysis demonstrated worse ACS outcome in patients with increase of EAT volume, as compared with those with decrease or constant of EAT volume during follow-up (p<0.001) (Figure).
Conclusion: This MDCT study demonstrated that persistent EAT accumulation was associated with increased prevalence of obstructive plaque and of plaques with high-risk features, resulting in unfavorable ACS outcomes in non-obese CAD patients.
Author Disclosures: K. Nakanishi: None. S. Fukuda: None. A. Tanaka: None. K. Otsuka: None. H. Yamashita: None. H. Taguchi: None. J. Yoshikawa: None. K. Shimada: None. M. Yoshiyama: None.
- © 2014 by American Heart Association, Inc.