title: Epicardial adipose tissue volume as a marker of coronary artery disease severity in patients with diabetes independent of coronary artery calcium: findings from the CTRAD study.
abstract: OBJECTIVE
  The association between epicardial adipose tissue (EAT) volume and coronary artery disease (CAD) severity was evaluated, independent of traditional risk factors and coronary artery calcium (CAC) scores, in patients with diabetes type 2 (DM-2) using cardiac computed tomography angiography (CTA).
  
  
  METHODS
  A multivariate analysis was utilized to assess for an independent association after calculating EAT volume, CAD severity, and calcium scores in 92 patients with DM-II from the CTRAD study. We graded CAD severity as none (normal coronaries), mild-moderate (<70% stenosis), and severe (70% or greater stenosis).
  
  
  RESULTS
  A total of 39 (42.3%) asymptomatic patients with diabetes did not have CAD; 30.4% had mild/moderate CAD; and 27.1% had severe CAD. Mean EAT volume was highest in patients with severe CAD (143.14 cm(3)) as compared to mild/moderate CAD (112.7 cm(3)), and no CAD (107.5 cm(3)) (p = 0.003). After adjustment of clinical risk factors, notably, CAC score, multivariate regression analysis showed EAT volume was an independent predictor of CAD severity in this sample (odds ratio 11.2, 95% confidence interval 1.7-73.8, p = 0.01).
  
  
  CONCLUSIONS
  Increasing EAT volume in asymptomatic patients with DM-II is associated with presence of severe CAD, independent of BMI and CAC, as well as traditional risk factors.
authors.affiliation: Department of Medicine, Division of Cardiology, University of California, 333 City Tower West, Suite 400, Orange, CA 92868, United States; Irvine-School of Medicine, Irvine, CA, United States.
authors.forename: Dilbahar S
authors.initials: DS
authors.lastname: Mohar
authors.affiliation: Department of Medicine, Division of Cardiology, University of California, 333 City Tower West, Suite 400, Orange, CA 92868, United States; Irvine-School of Medicine, Irvine, CA, United States.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Salcedo
authors.affiliation: Department of Medicine, Division of Cardiology, University of California, 333 City Tower West, Suite 400, Orange, CA 92868, United States; Irvine-School of Medicine, Irvine, CA, United States.
authors.forename: Khiet C
authors.initials: KC
authors.lastname: Hoang
authors.affiliation: Department of Medicine, Division of Cardiology, University of California, 333 City Tower West, Suite 400, Orange, CA 92868, United States; Irvine-School of Medicine, Irvine, CA, United States.
authors.forename: Shivesh
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Department of Medicine, Division of Cardiology, University of California, 333 City Tower West, Suite 400, Orange, CA 92868, United States; Irvine-School of Medicine, Irvine, CA, United States; Department of Radiology, University of Southern California, Los Angeles, CA, United States.
authors.forename: Farhood
authors.initials: F
authors.lastname: Saremi
authors.affiliation: Department of Medicine, Division of Cardiology, University of California, 333 City Tower West, Suite 400, Orange, CA 92868, United States; Irvine-School of Medicine, Irvine, CA, United States.
authors.forename: Ashwini S
authors.initials: AS
authors.lastname: Erande
authors.affiliation: Department of Medicine, Division of Cardiology, University of California, 333 City Tower West, Suite 400, Orange, CA 92868, United States; Irvine-School of Medicine, Irvine, CA, United States.
authors.forename: Nassim
authors.initials: N
authors.lastname: Naderi
authors.affiliation: Department of Medicine, Division of Cardiology, University of California, 333 City Tower West, Suite 400, Orange, CA 92868, United States; Irvine-School of Medicine, Irvine, CA, United States.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Nadeswaran
authors.affiliation: Department of Medicine, Division of Cardiology, University of California, 333 City Tower West, Suite 400, Orange, CA 92868, United States; Irvine-School of Medicine, Irvine, CA, United States; Department of Radiology, University of Southern California, Los Angeles, CA, United States.
authors.forename: Christine
authors.initials: C
authors.lastname: Le
authors.affiliation: Department of Medicine, Division of Cardiology, University of California, 333 City Tower West, Suite 400, Orange, CA 92868, United States; Irvine-School of Medicine, Irvine, CA, United States. Electronic address: smalik@uci.edu.
authors.forename: Shaista
authors.initials: S
authors.lastname: Malik
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging*; D015415:Biomarkers / Q000378:metabolism; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000209:etiology; D002118:Calcium / Q000378:metabolism; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000209:etiology; D003331:Coronary Vessels / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000000981:diagnostic imaging / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D010496:Pericardium / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D015415:Biomarkers; D002118:Calcium
keywords: Computed tomography angiography; Coronary artery disease; Diabetes; EAT; Multi-detector computed tomography; NCT01564485; Pericardial fat