title: Determination of pericardial adipose tissue increases the prognostic accuracy of coronary artery calcification for future cardiovascular events.
abstract: OBJECTIVE
  Pericardial adipose tissue (PAT) is associated with coronary artery plaque accumulation and the incidence of coronary heart disease. We evaluated the possible incremental prognostic value of PAT for future cardiovascular events.
  
  
  METHODS
  145 patients (94 males, age 60 ± 10 years) with stable coronary artery disease underwent coronary artery calcification (CAC) scanning in a multislice CT scanner, and the volume of pericardial fat was measured. Mean observation time was 5.4 years.
  
  
  RESULTS
  34 patients experienced a severe cardiac event. They had a significantly higher CAC score (1,708 ± 2,269 vs. 538 ± 1,150, p < 0.01), and the CAC score was highly correlated with the relative risk of a future cardiac event: 2.4 (1.8-3.7; p = 0.01) for scores >400, 3.5 (1.9-5.4; p = 0.007) for scores >800 and 5.9 (3.7-7.8; p = 0.005) for scores >1,600. When additionally a PAT volume >200 cm(3) was determined, there was a significant increase in the event rate and relative risk. We calculated a relative risk of 2.9 (1.9-4.2; p = 0.01) for scores >400, 4.0 (2.1-5.0; p = 0.006) for scores >800 and 7.1 (4.1-10.2; p = 0.005) for scores >1,600.
  
  
  CONCLUSIONS
  The additional determination of PAT increases the predictive power of CAC for future cardiovascular events. PAT might therefore be used as a further parameter for risk stratification.
authors.affiliation: Department of Cardiology, Klinikum Grosshadern, University Hospital of Munich, Munich, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Greif
authors.forename: Alexander Wolfgang
authors.initials: AW
authors.lastname: Leber
authors.forename: Tobias
authors.initials: T
authors.lastname: Saam
authors.forename: Christopher
authors.initials: C
authors.lastname: Uebleis
authors.forename: Franz
authors.initials: F
authors.lastname: von Ziegler
authors.forename: Janine
authors.initials: J
authors.lastname: Rümmler
authors.forename: Melvin
authors.initials: M
authors.lastname: D'Anastasi
authors.forename: Vivian
authors.initials: V
authors.lastname: Arias-Herrera
authors.forename: Christoph
authors.initials: C
authors.lastname: Becker
authors.forename: Gerhard
authors.initials: G
authors.lastname: Steinbeck
authors.forename: Marcus
authors.initials: M
authors.lastname: Hacker
authors.forename: Alexander
authors.initials: A
authors.lastname: Becker
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000000981:diagnostic imaging*; D011379:Prognosis; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D061205:Vascular Calcification / Q000000981:diagnostic imaging*