Why the study?
Changes in epicardial fat and interatrial septum thickness may represent risk factors for poor cardiovascular prognosis beyond traditional factors in coronary heart disease.
Do increased epicardial fat and interatrial septum thickness predict poor prognosis in patients with coronary heart disease?
Cohort (n=116)
No
Do increased epicardial fat and interatrial septum thickness predict poor prognosis in patients with coronary heart disease?
Relative Risk: 3.9
p-value: p=0.0012
Increased epicardial fat (≥0.8 cm) and interatrial septum thickness (≥0.7 cm) measured by echocardiography may serve as additional prognostic markers for poor outcomes in patients with coronary heart disease.
Epicardial fat assessment may refine CHD risk stratification now; extends RCT evidence for its independent prognostic role.
INTRODUCTION: Obesity is one of the leading risk factors for the development of cardiovascular diseases. At present, of the greatest scientific interest are local deposits of adipose tissue as a possible morphological substrate for the development of this group of diseases. Along with the traditional risk factors, one more risk factor for a poor prognosis of cardiovascular disease can be a change in the thickness of the epicardial fat (EF) and of the interatrial septum (IAS) in case of its lipomatosis. AIM: To study the significance of EF and of IAS thickness as markers of cardiovascular risk in coronary heart disease. MATERIALS AND METHODS: The study involved 116 individuals with coronary heart disease (55 men (47%) and 61 women (53%), mean age 68 [61; 72] years). Thickness of EF and IAS was evaluated by the method of echocardiography. The frequency of poor outcomes was evaluated using KaplanMeier method, ROC-curve analysis. The differences were considered statistically significant at p 0.05. RESULTS: In the group of patients with unstable angina, the threshold value of IAS thickness was 0.7 cm (p 0.001), and of EF thickness 0.8 cm (2 = 10.89, p = 0.001), in the group of patients with myocardial infarction 0.7 cm (p 0.001) and 0.8 cm (p 0.001), respectively. In the group of patient with unstable angina, IAS thickness 0.7 cm (2 = 10.3, p = 0.0013) and EF thickness 0.8 cm (2 = 10.89, p = 0.001) demonstrate a poor prognosis in comparison with the parameters below the threshold values. In the group of patients with myocardial infarction, IAS thickness 0.7 cm (2 = 8.4, p = 0.005) and EF 0.8 cm (2 = 9.66, p = 0.0019) demonstrate poor prognosis in comparison with the parameters below the threshold values. CONCLUSION: In unstable angina and myocardial infarction, the value of IAS thickness 0.7 cm (p = 0.0013 and p = 0.005, respectively) and of EF thickness 0.8 cm (p = 0.001 and p = 0.0019, respectively) present a poor prognosis compared to lower values. It is recommended that EF and IAS thickness be determined in echocardiography as an additional marker for a poor prognosis in coronary heart disease.
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Uryasyev et al. (2023) conducted a cohort in Coronary heart disease (unstable angina or myocardial infarction) (n=116). Epicardial fat thickness ≥ 0.8 cm vs. Epicardial fat thickness < 0.8 cm was evaluated on Combined clinical endpoint (death, nonfatal MI, return of angina, new-onset AF, nonfatal stroke) (RR 3.9, p=0.0012).
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