Coronary artery damage and epicardial fat in individuals with unstable angina pectoris

Introduction . The role of epicardial fat in the pathogenesis of atherosclerosis and coronary heart disease remains relevant. At the same time, the relationship between epicardial fat thickness and unstable angina is poorly understood. Aim . To study the relationship between coronary artery disease and epicardial fat thickness in individuals with unstable angina pectoris. Materials and methods . The study included 102 patients, 64 men, median age 62 (55; 67) years with unstable angina, who were hospitalized at the Regional Cardiology Center of the Kamchatka Regional Hospital from 2018 to 2019. Laboratory testing was performed to assess the levels of interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-alpha), leptin and adiponectin. Coronary artery stenting and echocardiography with measurement of epicardial adipose tissue (EAT) thickness were performed 1-3 days after hospitalization. The participants were divided into 2 groups based on the EAT thickness: Group 1 – patients with EAT thickness <7.6 mm (n = 46); Group 2 – EAT thickness >7.6 mm (n = 56). Results . There were no significant differences between the groups in terms of the main clinical and anamnestic indicators, such as gender, age, smoking history, and the presence and duration of hypertension. However, in individuals with epicardial adipose tissue thickness >7.6 mm, a significant increase in body fat (р = 0,004) and visceral fat was observed (р = 0,017). Additionally, there were significant increases in levels of leptin (р = 0,001), C-reactive protein (р = 0,007), interleukin-6 (р = 0,001), TNF-alpha (р = 0,001), and HDL (р = 0,002). Positive correlations were also found between EAT and IL-6 (ro = 0,589; р = 0,001) and leptin (ro = 0,318; р = 0,002). Multivessel coronary lesions were significantly more common in patients with EAT >7.6 mm. Conclusion . The measurement of epicardial adipose tissue thickness as an indirect assessment of the prevalence of coronary atherosclerosis in patients with unstable angina is a more informative method in comparison with the use of classical indicators of cardiometabolic risk.