title: Relationship of epicardial fat volume to coronary plaque, severe coronary stenosis, and high-risk coronary plaque features assessed by coronary CT angiography.
abstract: BACKGROUND
  Associations of epicardial fat volume (EFV) measured on noncontrast cardiac CT (NCT) include coronary plaque, myocardial ischemia, and adverse cardiac events.
  
  
  OBJECTIVE
  This study aimed to define the relationship of EFV to coronary plaque type, severe coronary stenosis, and the presence of high-risk plaque features (HRPFs).
  
  
  METHODS
  We retrospectively evaluated 402 consecutive patients, with no prior history of coronary artery disease, who underwent same day NCT and coronary CT angiography (CTA). EFV was measured on NCT with the use of validated, semiautomated software. The coronary arteries were evaluated for coronary plaque type (calcified [CP], noncalcified [NCP], or partially calcified [PCP]) and coronary stenosis severity ≥70% with the use of coronary CTA. For patients with NCP and PCP, 2 high-risk plaque features were evaluated: low-attenuation plaque and positive remodeling.
  
  
  RESULTS
  There were 402 patients with a median age of 66 years (range, 23-92 years) of whom 226 (56%) were men. The EFV was greater in patients with CP (112 ± 55 cm(3) vs 89 ± 39 cm(3)), PCP (110 ± 57 cm(3) vs 98 ± 45 cm(3)), and NCP (115 ± 44 cm(3) vs EFV 100 ± 52 cm(3)). In the 192 patients with PCP or NCP, on multivariable analysis, after adjusting for conventional cardiovascular risk factors, EFV was an independent predictor of ≥70% coronary artery stenosis (odds ratio [OR], 3.0; 95% CI, 1.3-6.6; P = 0.008), any high-risk plaque features (OR, 1.7; 95% CI, 0.9-3.4; P = 0.04), and low attention plaque (OR, 2.4; 95% CI, 1.1-5.1; P = 0.02) but not of positive remodeling.
  
  
  CONCLUSIONS
  EFV is greater in patients with CP, PCP, and NCP. In patients with NCP and PCP, EFV is significantly associated with severe coronary stenosis, high-risk plaque features, and low attenuation plaque.
authors.affiliation: Department of Imaging, Cedars-Sinai Medical Center, Cedars-Sinai Heart Institute, 8700 Beverly Blvd., Los Angeles, CA 90048, USA.
authors.forename: Ronak
authors.initials: R
authors.lastname: Rajani
authors.forename: Haim
authors.initials: H
authors.lastname: Shmilovich
authors.forename: Ryo
authors.initials: R
authors.lastname: Nakazato
authors.forename: Rine
authors.initials: R
authors.lastname: Nakanishi
authors.forename: Yuka
authors.initials: Y
authors.lastname: Otaki
authors.forename: Victor Y
authors.initials: VY
authors.lastname: Cheng
authors.forename: Sean W
authors.initials: SW
authors.lastname: Hayes
authors.forename: Louise E J
authors.initials: LE
authors.lastname: Thomson
authors.forename: John D
authors.initials: JD
authors.lastname: Friedman
authors.forename: Piotr J
authors.initials: PJ
authors.lastname: Slomka
authors.forename: James K
authors.initials: JK
authors.lastname: Min
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Berman
authors.forename: Damini
authors.initials: D
authors.lastname: Dey
mesh_terms: D050154:Adiposity; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D017023:Coronary Angiography / Q000706:statistics & numerical data*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D010496:Pericardium / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D055815:Young Adult