CT-derived epicardial adipose tissue attenuation was independently associated with the occurrence of type-I myocardial infarction (OR 2.04) in a model containing EAT volume.
Case-Control (n=94)
No
Does CT-derived epicardial adipose tissue attenuation, in addition to volume, distinguish patients with and without myocardial infarction?
CT-derived epicardial adipose tissue attenuation provides complementary information to EAT volume in distinguishing patients with myocardial infarction from those with stable coronary artery disease.
Odds Ratio: 2.04 (95% CI 1.18–3.53)
p-value: p=0.01
BACKGROUND AND OBJECTIVE: Epicardial adipose tissue (EAT) volume is associated with coronary plaque burden and adverse events. We aimed to determine, whether CT-derived EAT attenuation in addition to EAT volume distinguishes patients with and without myocardial infarction. METHODS AND RESULTS: In 94 patients with confirmed or suspected coronary artery disease (aged 66.9±14.7years, 61%male) undergoing cardiac CT imaging as part of clinical workup, EAT volume was retrospectively quantified from non-contrast cardiac CT by delineation of the pericardium in axial images. Mean attenuation of all pixels from EAT volume was calculated. Patients with type-I myocardial infarction (n = 28) had higher EAT volume (132.9 ± 111.9ml vs. 109.7 ± 94.6ml, p = 0.07) and CT-attenuation (-86.8 ± 5.8HU vs. -89.0 ± 3.7HU, p = 0.03) than patients without type-I myocardial infarction, while EAT volume and attenuation were only modestly inversely correlated (r = -0.24, p = 0.02). EAT volume increased per standard deviation of age (18.2 6.2-30.2 ml, p = 0.003), BMI (29.3 18.4-40.2 ml, p<0.0001), and with presence of diabetes (44.5 16.7-72.3 ml, p = 0.0002), while attenuation was higher in patients with lipid-lowering therapy (2.34 0.08-4.61 HU, p = 0.04). In a model containing volume and attenuation, both measures of EAT were independently associated with the occurrence of type-I myocardial infarction (OR 95% CI: 1.79 1.10-2.94, p = 0.02 for volume, 2.04 1.18-3.53, p = 0.01 for attenuation). Effect sizes remained stable for EAT attenuation after adjustment for risk factors (1.44 0.77-2.68, p = 0.26 for volume; 1.93 1.11-3.39, p = 0.02 for attenuation). CONCLUSION: CT-derived EAT attenuation, in addition to volume, distinguishes patients with vs. without myocardial infarction and is increased in patients with lipid-lowering therapy. Our results suggest that assessment of EAT attenuation could render complementary information to EAT volume regarding coronary risk burden.
Mahabadi et al. (Thu,) conducted a case-control in Coronary artery disease (n=94). CT-derived epicardial adipose tissue attenuation vs. Patients without myocardial infarction was evaluated on Occurrence of type-I myocardial infarction (OR 2.04, 95% CI 1.18-3.53, p=0.01). CT-derived epicardial adipose tissue attenuation was independently associated with the occurrence of type-I myocardial infarction (OR 2.04) in a model containing EAT volume.