What is the clinical evidence from this study?

Study design: Observational. Population: Coronary artery disease (n=255). Intervention: Epicardial fat volume (EFV) and pericoronary fat tissue thickness (PCFT) assessment vs. Non-atherosclerotic group (Coronary calcium score = 0). Primary outcome: Epicardial fat volume (EFV) in patients with coronary calcium (CS≥1) (p=<0.001).

What question did this study set out to answer?

This research aims to examine the connections between epicardial fat metrics and coronary artery disease severity.

March 21, 2026Open Access

The role of epicardial adipose tissue volume and pericoronary fat thickness in the evaluation of coronary artery disease

Q: What are the key findings of this study?

Epicardial fat volume was significantly higher in patients with coronary calcium (204.3 vs 153.1) and independently predicted the presence of atherosclerosis (OR 1.006).

Q: What question did this study set out to answer?

This research aims to examine the connections between epicardial fat metrics and coronary artery disease severity.

Key Result

Epicardial fat volume was significantly higher in patients with coronary calcium (204.3 vs 153.1) and independently predicted the presence of atherosclerosis (OR 1.006).

Key Points

This research aims to examine the connections between epicardial fat metrics and coronary artery disease severity.
Retrospective analysis of 255 patients who underwent cardiac CT angiography
Measured epicardial fat volume, density, and pericoronary fat thickness
Performed statistical analyses including binary logistic and ordinal regression
Epicardial fat volume and pericoronary fat thickness were higher in atherosclerotic individuals
Epicardial fat density was lower in the atherosclerotic group
Positive correlation between epicardial fat volume and coronary calcium score
Age, diabetes, hypertension, and epicardial fat metrics correlated with coronary calcium presence

Study Design

Type

Observational (n=255)

Multicenter

Structured PICO

Do epicardial fat volume and pericoronary fat thickness correlate with the presence of coronary artery calcium in patients undergoing cardiac CT?

Population

255 adults (age >18) who underwent cardiac CT angiography, mean age 54.1, 66.3% male. Exclusions: presence of an artifact that would interfere with assessment, presence of a coronary stent, or presence of a coronary bypass.

Intervention

Measurement of epicardial fat volume (EFV), epicardial fat tissue density (EFD), and pericoronary fat tissue thickness (PCFT) via non-contrast cardiac CT.

Comparator

Patients without coronary calcium (CS=0) compared to those with coronary calcium (CS≥1).

Outcome

Presence of coronary calcium (Agatston-equivalent calcium score ≥1).surrogate

Epicardial fat volume and right coronary artery pericoronary fat thickness measured on non-contrast CT are independent predictors of coronary artery calcification.

Main Result

Absolute Event Rate: 204.3% vs 153.1%

p-value: p=<0.001

Limitations

Single-center study with a relatively small sample size
Unable to access data on the patients' medications and lifestyles
Retrospective design, unable to evaluate the prognostic effects of EFV and EFD

Abstract

Aims: To investigate the relationships between epicardial fat volume (EFV), epicardial fat tissue density (EFD), and pericoronary fat tissue thickness (PCFT) and the coronary calcium score (CS). Epicardial fat tissue, which surrounds the coronary arteries, is thought to be associated with cardiovascular diseases. Methods: The study was conducted retrospectively on 255 patients who underwent cardiac CT angiography between January 2025 and October 2025. EFV, EFD, and PCFT measurements were performed on the study participants.Results: The analysis revealed that EFV and PCFT were significantly higher in the atherosclerotic group, whereas EFD was lower in this group. Additionally, a significant positive correlation was observed between EFV and coronary calcium, whereas no significant correlation was observed with EFD. In the binary logistic regression analysis, age, diabetes, hypertension, EFV, and RCA-PCFT were associated with the presence of coronary calcium. Furthermore, in ordinal regression, only hypertension and age were associated with the calcium score.Conclusion: The findings of this study suggest that epicardial fat may serve as a biomarker for coronary artery disease.

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