Key result
High epicardial adipose tissue volume was significantly associated with the presence of non-calcified coronary plaques in patients with a coronary artery calcium score of zero, even among those with low visceral adipose tissue area (OR 3.02).
Why the study?
Is high epicardial and abdominal visceral adipose tissue associated with the presence of non-calcified coronary plaques in patients with a CAC score of zero?
Cross-Sectional (n=352)
No
Is high epicardial and abdominal visceral adipose tissue associated with the presence of non-calcified coronary plaques in patients with a CAC score of zero?
Odds Ratio: 3.02 (95% CI 1.33–6.9)
Absolute Event Rate: 37% vs 14%
p-value: p=0.008
In patients with a CAC score of zero, high epicardial adipose tissue volume is independently associated with the presence of non-calcified coronary plaques, even in the absence of abdominal obesity.
May flag higher-risk zero-CAC subsets for monitoring; hypothesis-generating and requires prospective validation before practice change.
BACKGROUND: We sought to examine whether epicardial and abdominal visceral adipose tissue distribution is associated with coronary atherosclerosis in patients with a coronary artery calcium (CAC) score of zero, assessed by coronary computed tomography angiography (CCTA). METHODS AND RESULTS: We studied 352 patients with suspected coronary artery disease (mean age 61±11 years, 57% male) with a CAC score of zero who had undergone CCTA. Non-calcified coronary plaques (NCPs) were detected in 102 patients (29%); those causing ≥50% stenosis were found in 15 patients (4%). Patients were divided into 4 groups on the basis of CT-based epicardial adipose tissue (EAT) volume and abdominal visceral adipose tissue (VAT) area using the sex-specific median value. Multivariate analysis showed that the adjusted odds ratios for the presence of NCPs in the high VAT area/low EAT volume group, and the high VAT area/high EAT volume group were 2.80 (95% confidence interval [95% CI]: 1.25-6.35, P=0.01) and 2.68 (95% CI: 1.36-5.45, P=0.004), respectively. Interestingly, the low VAT area/high EAT volume group showed an equivalent adjusted odds ratio of 3.02 (95% CI: 1.33-6.90, P=0.008). CONCLUSIONS: EAT volume is eligible as a marker to be evaluated in addition to VAT area in patients with a CAC score of zero.
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Tsushima et al. (2015) conducted a cross-sectional in Suspected coronary artery disease with a coronary artery calcium score of zero (n=352). High epicardial adipose tissue (EAT) volume vs. Low epicardial adipose tissue (EAT) volume and low visceral adipose tissue (VAT) area was evaluated on Presence of non-calcified coronary plaques (NCPs) (OR 3.02, 95% CI 1.33-6.90, p=0.008). High epicardial adipose tissue volume was significantly associated with the presence of non-calcified coronary plaques in patients with a coronary artery calcium score of zero, even among those with low visceral adipose tissue area (OR 3.02).
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