Epicardial adipose tissue not linked to major adverse coronary events in CAD
American 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 occurred.
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, 0.88-3.5).
“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 financial disclosures.
For more information:
- Albuquerque FN. Poster 290. Presented at: ACC 60th Annual Scientific Sessions; April 2-5, 2011; New Orleans.
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