What question did this study set out to answer?

This research aims to determine the relationship between epicardial adipose tissue volume and the severity of coronary artery disease.

March 29, 2026

SRS275 - The association between epicardial adipose tissue measurement and the severity of coronary artery disease: a systematic review and network meta-analysis across severity strata

Key Result

Epicardial adipose tissue volume is 26.2 cm³ higher in patients with coronary artery disease than those without, and increases linearly by 10.17 cm³ per severity level.

Key Points

This research aims to determine the relationship between epicardial adipose tissue volume and the severity of coronary artery disease.
Conducted a systematic review and meta-analysis of 47 studies.
Compared EAT volumes in CAD patients versus non-CAD participants.
Used random effects models for data analysis in R.
Performed meta-regression to assess the relationship between EAT volume and CAD severity.
Patients with CAD have significantly higher EAT volumes than those without CAD (mean difference: 26.2 cm³).
Severe CAD is associated with a larger increase in EAT volume compared to mild CAD (mean difference: 30.88 mL).
Non-CAD individuals have significantly lower EAT volumes (mean difference = −13.53 mL).
A significant linear relationship exists between EAT volume and CAD severity (estimate per severity level: 10.17 cm³).

Structured PICO

Does higher epicardial adipose tissue (EAT) volume correlate with the presence and severity of coronary artery disease?

Population

15,976 participants across 47 studies, including patients with coronary artery disease (CAD) of varying severity and non-CAD controls.

Intervention

Epicardial adipose tissue (EAT) volume measurement

Comparator

Patients without CAD or with mild CAD

Outcome

Difference in EAT volume between CAD and non-CAD patients, and correlation with CAD severitysurrogate

Epicardial adipose tissue volume is significantly higher in patients with coronary artery disease and correlates linearly with disease severity, supporting its potential use as a non-invasive imaging biomarker.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Abstract The role of epicardial adipose tissue (EAT) as a metabolically active fat store has attracted increasing interest. However, how EAT volume relates to the severity of coronary artery disease (CAD) remains unclear. We conducted a systematic review and meta-analysis to compare EAT volumes in patients with and without CAD and assess if higher EAT volume correlates with more severe CAD. This study was registered in PROSPERO (CRD42023466043). We searched PubMed, Embase, and Scopus for studies reporting EAT volume in CAD patients versus non-CAD or based on severity up to 11 February 2025. Covidence was used for study selection, data extraction, and quality assessment. Meta-analyses were conducted in R using random effects models. By analysing 47 studies involving a total of 15976 participants, we found that, in pairwise analysis, patients with CAD had significantly higher EAT volumes than those without CAD (mean difference: 26.2 cm³, 95% c.i.: 21.5–31.0, P 0.001; I² = 94.7%). In the network meta-analysis, severe CAD caused the largest increase in EAT volume compared to mild CAD (mean difference = 30.88 mL, 95% c.i.: 20.21–41.55), whilst non-CAD was associated with a significantly lower volume (mean difference = −13.53 mL, 95% c.i.: −22.67 to −4.40). Meta-regression demonstrated a significant linear relationship between EAT volume and CAD severity (estimate per severity level: 10.17 cm³, 95% c.i.: 1.36–18.98, P = 0.0236). Conclusions: The current findings suggest that EAT could serve as a non-invasive imaging biomarker to assess the severity of coronary artery disease.

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