Pericardial adipose tissue was independently associated with severe CAD (OR 1.61; 95% CI 1.08-2.40; P<0.03) and plaque burden, outperforming visceral fat and visceral-to-subcutaneous fat ratio.
Cross-Sectional (n=181)
Does pericardial adipose tissue (PAT) better predict CAD severity and atherosclerotic plaque burden compared to other adiposity measures in symptomatic patients undergoing coronary CT angiography?
Pericardial adipose tissue is a more reliable independent predictor of coronary artery disease severity and plaque burden than visceral or subcutaneous fat measures.
Effect estimate: OR 1.61 (95% CI 1.08-2.40)
p-value: p=< 0.03
RATIONALE AND OBJECTIVES Adipose tissue measures have long been investigated for their prognostic value in coronary artery disease (CAD). Some of these measures include subcutaneous and visceral fat (SAT and VAT), the VAT-to-SAT ratio (VSR), and pericardial adipose tissue (PAT). While VSR and PAT have been separately suggested as prominent measures, a direct comparison of their roles in predicting CAD severity and atherosclerotic plaque burden remains unclear. Hence, this study aims to assess the association of adiposity measures with CAD. MATERIALS AND METHODS In this cross-sectional study, 181 symptomatic patients undergoing coronary computed tomography (CT) angiography were assessed for coronary stenosis severity using the CAD-reporting and data system (CAD-RADS) 2.0, and for overall plaque burden using the segment involvement score (SIS) and the coronary artery calcium (CAC) score. Adipose tissue measures were quantified from CT images. Spearman correlations and univariate and multivariate logistic regression analyses (adjusted for age and sex) evaluated associations with severe CAD (CAD-RADS ≥ 3) and plaque burden (CAC Score ≥ 100 and SIS ≥ 3). RESULTS In contrast to SAT, PAT and VAT significantly correlated with all scoring systems. In univariate analyses, all adiposity measures, except for SAT, were significantly associated with severe CAD and plaque burden. However, only PAT remained independently associated with severity across all three scoring systems (CAD-RADS OR: 1.61 1.08-2.40; SIS OR: 1.56 1.05-2.32; CAC OR: 1.82 1.18-2.80; P < 0.03) after adjustment. CONCLUSION PAT is the most reliable adiposity measure of CAD severity and plaque burden, outperforming both VAT and VSR, suggesting it as an invaluable prognostic marker in cardiac imaging.
Zendehdel et al. (Sun,) conducted a cross-sectional in Coronary artery disease (n=181). Pericardial adipose tissue (PAT) measurement vs. Visceral adipose tissue (VAT) and VAT-to-SAT ratio (VSR) was evaluated on Severe CAD (CAD-RADS ≥ 3) and plaque burden (CAC Score ≥ 100 and SIS ≥ 3) (OR 1.61, 95% CI 1.08-2.40, p=< 0.03). Pericardial adipose tissue was independently associated with severe CAD (OR 1.61; 95% CI 1.08-2.40; P<0.03) and plaque burden, outperforming visceral fat and visceral-to-subcutaneous fat ratio.