Epicardial adipose tissue and new-onset atrial fibrillation in a Danish cohort

Atrial fibrillation (AF) affects one in three individuals of European ancestry, with obesity recognized as a major risk factor.1 However, body mass index (BMI) does not account for ectopic fat distribution, and epicardial adipose tissue (EAT) may play a distinct role. EAT is a visceral fat depot surrounding the myocardium.2 The proximity to the myocardium permits local inflammation and fibrotic effects, potentially contributing to AF development.3,4 While EAT has been linked to AF prevalence in previous population-based research, its association with incident AF remains unclear.5 We investigated the association between EAT volume assessed by computed tomography angiography (CTA) and incident AF in a general population cohort. We included participants from the Copenhagen General Population Study (CGPS), a population-based cohort from the Greater Copenhagen area. Between February 2010 and February 2012, CGPS cohort members were invited to undergo a cardiac CTA scan at Copenhagen University Hospital, Rigshospitalet. For inclusion in the CTA examination, participants had to be aged ≥40 years old and have normal kidney function defined by serum creatinine levels <100 µmol/L. All participants provided written informed consent, and the study was approved by the Danish National Committee on Biomedical Research Ethics (H-KF-01-144/01).