College of Cardiology 60th Annual Scientific Sessions
NEW ORLEANS — In patients with coronary artery
disease, epicardial adipose tissue was not strongly associated with major
adverse cardiovascular events, according to data from a longitudinal study.
“The main purpose of this research was to look at
the prognostic values of epicardial fat, as measured by echocardiography. There
are few studies showing a positive correlation between epicardial fat and
atrial fibrillation and also between epicardial fat and coronary artery
disease,” Felipe Albuquerque, MD, medical resident at the Hospital
of Saint Raphael, Yale School of Medicine and former research fellow at the
Mayo Clinic in Rochester, Minn., told Endocrine Today.
To do this, Albuquerque and colleagues conducted a
longitudinal study of 194 patients with CAD who had entered a phase 2 cardiac
rehabilitation program. Transthoracic echocardiograms were performed within 6
months of enrollment into the rehabilitation program.
According to the abstract, the maximum epicardial
adipose tissue “was measured on the free wall of the right ventricle,
using the aortic annulus as reference, at the parasternal long-axis view at
end-systole in three cardiac cycles.” The average was derived from three
measurements and patients were classified as having epicardial adipose tissue
above or below the mean. The primary endpoint was major adverse coronary
events, including acute coronary syndrome, coronary revascularization, stroke,
ventricular arrhythmias and death.
Eighty percent of patients were men and 21% underwent
coronary artery bypass graft, according to the researchers. Mean follow-up was
3.6 ± 1.3 years, at which point 57 major adverse coronary events had
BMI, body fat percentage, lean weight and waist
circumference were similar between the above the mean and below the mean
groups; patients with epicardial adipose tissue above the mean were older
(P=.003). Rates of major adverse coronary events were also similar
between the two groups (HR=1.23; 95% CI, 0.73-2.1). This remained true after
adjusting for age, sex and BMI (HR for above the mean=1.19; 95% CI, 0.68-2.06).
However, when stratified by tertiles, epicardial adipose tissue was associated
with a non-significant trend for major adverse coronary events (HR for the
second tertile=1.15; 95% CI, 0.55-2.38; HR for the third tertile=1.75; 95% CI,
“Epicardial fat is a noninvasive measurement,
linked to coronary artery disease (CAD) in few studies, but our data suggest
that in patients with CAD it does not strongly predict mortality after a
follow-up of approximately 4 years,” Albuquerque said. “Further
studies are needed to assess the prognostic values of epicardial fat in the
general population and its long-term outcomes.”
Disclosure: Dr. Albuquerque reports no relevant
For more information:
- Albuquerque FN. Poster 290. Presented at: ACC 60th Annual
Scientific Sessions; April 2-5, 2011; New Orleans.