Abstract
Objective: Pericardial adipose tissue (PAT) is a pathogenic fat depot associated with coronary atherosclerosis and cardiovascular events. We hypothesized that higher PAT is associated with coronary high-risk lesions as determined by cardiac CT. Methods: We included 358 patients (38% female; median age 51 years) who were admitted to the ED with acute chest pain and underwent 64-slice CT angiography. The cardiac CT data sets were assessed for presence and morphology of CAD and PAT. Coronary high-risk lesions were defined as >50% luminal narrowing and at least two of the following characteristics: positive remodeling, low-density plaque, and spotty calcification. PAT was defined as any pixel with CT attenuation of -190 to -30. HU within the pericardial sac. Results: Based on cardiac CT, 50% of the patients (n=180) had no CAD, 46% (n=165) had CAD without high-risk lesions, and 13 patients had CAD with high-risk lesions. The median PAT in patients with high-risk lesions was significantly higher compared to patients without high-risk lesions and without any CAD (151.9 [109.0-179.4]cm 3 vs. 110.0 [81.5-137.4]cm 3, vs. 74.8 [58.2-111.7]cm 3, respectively p=0.04 and p<0.0001). These differences remained significant after adjusting for traditional risk factors including BMI (all p<0.05). The area under the ROC curve for the identification of high-risk lesions was 0.756 in a logistic regression model with PAT as a continuous predictor. Conclusion: PAT volume is nearly twice as high in patients with high-risk coronary lesions as compared to those without CAD. PAT volume is significantly associated with high risk coronary lesion morphology independent of clinical characteristics and general obesity.
Original language | English (US) |
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Pages (from-to) | 129-134 |
Number of pages | 6 |
Journal | Atherosclerosis |
Volume | 222 |
Issue number | 1 |
DOIs | |
State | Published - May 2012 |
Externally published | Yes |
Keywords
- Adipose tissue
- Cardiac CT angiography
- Coronary artery disease
- High-risk lesions
- Peri-cardial fat
- Vulnerable plaque
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine