Key result
Larger pericardial fat area on routine chest CT discriminates CAD with ~0.70 AUC.
Why the study?
Previous studies measured pericardial fat volume using contrast-enhanced cardiac CT, but the association of pericardial fat area determined by routine chest CT with coronary risk factors and CAD was unclear.
Is pericardial fat area measured by routine chest CT associated with coronary artery disease and coronary risk factors?
Cross-Sectional (n=53)
No
Is pericardial fat area measured by routine chest CT associated with coronary artery disease and coronary risk factors?
Effect estimate: AUC 0.697 (95% CI 0.434-0.822)
Pericardial fat area measured by routine chest CT is significantly associated with coronary artery disease and may serve as a simple, reproducible marker for CAD risk.
May aid CAD risk stratification on routine CT; hypothesis-generating and requires prospective validation before practice change.
Background: Pericardial fat has been reported to be associated with coronary risk factors and severity of coronary arterial lesions. Previous studies had measured pericardial fat volume (PFV) by using contrast-enhanced cardiac computed tomography (CT) when pericardial fat was quantified. We determined pericardial fat area (PFA) in the cross section with the height of sternal angle by using routine chest CT. Methods: We picked up 252 patients who underwent chest and abdominal CT, and we selected patients whose coronary arteries were evaluated by coronary angiography or coronary CT. Coronary artery disease (CAD) was defined as more than 75% lumen stenosis. PFA was defined as any pixel with CT attenuation of -150 to -30 Hounsfield Unit (HU) within the pericardial sac at the sternal angle level. Results: Fifty-three patients were eligible. PFA was significantly larger in men than in women. Serum high-density lipoprotein (HDL)-cholesterol level was significantly and negatively correlated with PFA. Hemoglobin A1c and carotid arterial intima-media thickness tended to be positively correlated with PFA. PFA was significantly and nearly 50% larger in patients with CAD than in patients without CAD. The cut-off value of PFA was 10.4 cm 2 , and sensitivity and specificity of PFA for CAD were 53.8% and 88.0%, respectively. Conclusions: Present study is the first to show a significant association of PFA with gender and CAD. PFA can be determined by routine chest CT, and is simpler and more reproducible, and PFA is more available in a greater number of medical institutes as compared with PFV. Present study also showed a discriminatory value of PFA for CAD comparable to PFV. J Clin Med Res. 2019;11(4):289-296 doi: https://doi.org/10.14740/jocmr3782
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Yoshikawa et al. (2019) conducted a cross-sectional in Coronary artery disease (n=53). Pericardial fat area vs. Patients without coronary artery disease was evaluated on Discriminatory value of pericardial fat area for coronary artery disease (AUC 0.697, 95% CI 0.434-0.822). Pericardial fat area determined by routine chest CT was significantly larger in patients with coronary artery disease and demonstrated a discriminatory value for CAD with an AUC of 0.697.
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