title: The different association of epicardial fat with coronary plaque in patients with acute coronary syndrome and patients with stable angina pectoris: analysis using integrated backscatter intravascular ultrasound.
abstract: OBJECTIVE
  We assessed the hypothesis that the epicardial fat is associated with coronary lipid plaque.
  
  
  BACKGROUND
  Epicardial fat volume (EFV) is increased in patients with acute coronary syndrome (ACS), and lipid-rich plaques have been associated with acute coronary events.
  
  
  METHODS
  We enrolled 112 individuals who underwent percutaneous coronary intervention (PCI) (66 with ACS; 46 with stable angina pectoris [SAP]) and classified plaque components using integrated backscatter intravascular ultrasound as calcified, fibrous, or lipid. Possible effects of PCI on plaque data were minimized by assessing 10-mm vessel lengths proximal to the culprit lesions. Total plaque volume and percentage volumes of individual plaque components were calculated. EFV and abdominal visceral fat area were measured using 64-slice computed tomography.
  
  
  RESULTS
  ACS patients had significantly higher EFV than did SAP patients (118 ± 44 vs.101 ± 41 mL, p = 0.019). In ACS patients, EFV was correlated with total plaque volume and percentage of lipid plaque (r = 0.27 and 0.31, respectively; p < 0.05). Moreover, an independent interaction between EFV and lipid-rich plaque (odds ratio, 1.04; 95% confidence interval, 1.00-1.07) were revealed. In contrast, in SAP patients, EFV was positively correlated with body mass index and abdominal visceral fat area but not with plaque characteristics.
  
  
  CONCLUSIONS
  EFV was associated with lipid-rich plaque in patients with ACS, whereas no correlation between EFV and coronary plaque profile was apparent in SAP patients. Epicardial fat may have a role in the development of lipid plaque, which contributes to the pathogenesis of ACS.
authors.affiliation: Department of Cardiology, Chubu Rosai Hospital, Nagoya, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Harada
authors.affiliation: Department of Cardiology, Chubu Rosai Hospital, Nagoya, Japan. Electronic address: haraken@med.nagoya-u.ac.jp.
authors.forename: Ken
authors.initials: K
authors.lastname: Harada
authors.affiliation: Department of Cardiology, Chubu Rosai Hospital, Nagoya, Japan.
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Uetani
authors.affiliation: Department of Cardiology, Chubu Rosai Hospital, Nagoya, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kataoka
authors.affiliation: Department of Cardiology, Chubu Rosai Hospital, Nagoya, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Takeshita
authors.affiliation: Department of Cardiology, Chubu Rosai Hospital, Nagoya, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Kunimura
authors.affiliation: Department of Cardiology, Chubu Rosai Hospital, Nagoya, Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Takayama
authors.affiliation: Department of Cardiology, Chubu Rosai Hospital, Nagoya, Japan.
authors.forename: Norihiro
authors.initials: N
authors.lastname: Shinoda
authors.affiliation: Department of Cardiology, Chubu Rosai Hospital, Nagoya, Japan.
authors.forename: Bunichi
authors.initials: B
authors.lastname: Kato
authors.affiliation: Department of Cardiology, Chubu Rosai Hospital, Nagoya, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Kato
authors.affiliation: Department of Cardiology, Chubu Rosai Hospital, Nagoya, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Marui
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishii
authors.affiliation: Department of Internal Medicine, Aichi-Gakuin School of Dentistry, Nagoya, Japan.
authors.forename: Tatsuaki
authors.initials: T
authors.lastname: Matsubara
authors.affiliation: Department of Cardiology, Aichi Medical University, Nagakute, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Amano
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Murohara
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging*; D000273:Adipose Tissue / Q000000981:diagnostic imaging*; D000368:Aged; D000787:Angina Pectoris / Q000000981:diagnostic imaging*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001823:Body Composition; D015992:Body Mass Index; D002114:Calcinosis / Q000000981:diagnostic imaging; D002118:Calcium / Q000032:analysis; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006949:Hyperlipidemias / Q000188:drug therapy / Q000453:epidemiology; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging; D007564:Japan / Q000453:epidemiology; D008055:Lipids / Q000032:analysis / Q000097:blood; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D062645:Percutaneous Coronary Intervention; D010496:Pericardium / Q000000981:diagnostic imaging*; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging* / Q000378:metabolism; D011446:Prospective Studies; D011859:Radiography; D012307:Risk Factors; D018084:Ultrasonography, Interventional / Q000379:methods*
chemical_list: D000959:Antihypertensive Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids; D002118:Calcium
keywords: 64-Slice computed tomography; Acute coronary syndrome; Coronary plaque; Epicardial fat volume; IB-IVUS; Stable angina pectoris