Key result
Higher EATVi links to increased long-term MACE risk in CMR-confirmed MINOCA.
Why the study?
The predictive value and incremental prognostic utility of epicardial adipose tissue for long-term MACE in CMR-confirmed MINOCA needed evaluation.
Does higher epicardial adipose tissue volume index predict long-term major adverse cardiovascular events in patients with CMR-confirmed MINOCA?
Cohort (n=117)
No
Does higher epicardial adipose tissue volume index predict long-term major adverse cardiovascular events in patients with CMR-confirmed MINOCA?
p-value: p=0.002
In patients with CMR-confirmed MINOCA, higher epicardial adipose tissue volume index is associated with an increased long-term risk of major adverse cardiovascular events.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Risk stratification for secondary prevention in CMR-confirmed MINOCA patients remains grossly inadequate. EAT possesses unique anatomical and metabolic characteristics that distinguish it from other visceral fat depots. However, given the close relationship between EATVi, visceral adiposity and metabolic dysfunction, residual or combined confounding cannot be fully excluded. Therefore, these findings should be interpreted as supporting a prognostic association rather than establishing an independent or causal effect of EATVi.”
“Risk stratification for secondary prevention in CMR-confirmed MINOCA patients remains grossly inadequate. EAT possesses unique anatomical and metabolic characteristics that distinguish it from other visceral fat depots.”
May aid risk stratification in MINOCA; hypothesis-generating and requires prospective validation before clinical adoption.
BACKGROUND: Cardiac magnetic resonance (CMR) serves as a pivotal diagnostic tool for myocardial infarction with nonobstructive coronary arteries (MINOCA) and enables the precise quantification of epicardial adipose tissue (EAT). OBJECTIVES: This study aimed to evaluate the predictive value of EAT for long-term major adverse cardiovascular events (MACE) in CMR-confirmed MINOCA and to determine whether EAT provides incremental prognostic utility. METHODS: This single-center retrospective study enrolled 117 patients with a working diagnosis of MINOCA who demonstrated an ischemic myocardial injury pattern on CMR after exclusion of nonischemic mimics or normal CMR findings. EAT volume was divided by body surface area to yield the EAT volume index (EATVi). RESULTS: (selection-adjusted P = 0.002). CONCLUSIONS: Among patients with CMR-confirmed MINOCA, higher EATVi was associated with an increased long-term risk of MACE. Given the potential influence of metabolic factors and residual confounding, these findings require validation in larger external cohorts.
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Chen et al. (2026) conducted a cohort in CMR-confirmed MINOCA (n=117). Epicardial Adipose Tissue Volume Index (EATVi) was evaluated on Major adverse cardiovascular events (MACE) (p=0.002). Higher epicardial adipose tissue volume index was associated with an increased long-term risk of major adverse cardiovascular events in patients with CMR-confirmed MINOCA (P=0.002).
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