The association of pericardial fat with incident coronary heart disease: the Multi-Ethnic Study of Atherosclerosis (MESA).
BACKGROUND
Pericardial fat (ie, fat around the heart) may have a direct role in the atherosclerotic process in coronary arteries through local release of inflammation-related cytokines. Cross-sectional studies suggest that pericardial fat is positively associated with coronary artery disease independent of total body fat.


OBJECTIVE
We investigated whether pericardial fat predicts future coronary heart disease events.


METHODS
We conducted a case-cohort study in 998 individuals, who were randomly selected from 6814 Multi-Ethnic Study of Atherosclerosis (MESA) participants and 147 MESA participants (26 from those 998 individuals) who developed incident coronary heart disease from 2000 to 2005. The volume of pericardial fat was determined from cardiac computed tomography at baseline.


RESULTS
The age range of the subjects was 45-84 y (42% men, 45% white, 10% Asian American, 22% African American, and 23% Hispanic). Pericardial fat was positively correlated with both body mass index (correlation coefficient = 0.45, P < 0.0001) and waist circumference (correlation coefficient = 0.57, P < 0.0001). In unadjusted analyses, pericardial fat (relative hazard per 1-SD increment: 1.33; 95% CI: 1.15, 1.54), but not body mass index (1.00; 0.84, 1.18), was associated with the risk of coronary heart disease. Waist circumference (1.14; 0.97, 1.34; P = 0.1) was marginally associated with the risk of coronary heart disease. The relation between pericardial fat and coronary heart disease remained significant after further adjustment for body mass index and other cardiovascular disease risk factors (1.26; 1.01, 1.59). The relation did not differ by sex.


CONCLUSIONS
Pericardial fat predicts incident coronary heart disease independent of conventional risk factors, including body mass index.
Ding
Jingzhong
J
Sticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, NC, USA. jding@wfubmc.edu
Hsu
Fang-Chi
FC
Harris
Tamara B
TB
Liu
Yongmei
Y
Kritchevsky
Stephen B
SB
Szklo
Moyses
M
Ouyang
Pamela
P
Espeland
Mark A
MA
Lohman
Kurt K
KK
Criqui
Michael H
MH
Allison
Matthew
M
Bluemke
David A
DA
Carr
J Jeffrey
JJ
D000273:Adipose Tissue / Q000000981:diagnostic imaging; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000150:complications / Q000000981:diagnostic imaging / Q000208:ethnology; D015992:Body Mass Index; D016022:Case-Control Studies; D015331:Cohort Studies; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000000981:diagnostic imaging; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D055105:Waist Circumference