title: Epicardial adipose tissue thickness correlates with the presence and severity of angiographic coronary artery disease in stable patients with chest pain.
abstract: OBJECTIVE
  Epicardial adipose tissue (EAT) is suggested to correlate with metabolic risk factors and to promote plaque development in the coronary arteries. We sought to determine whether EAT thickness was associated or not with the presence and extent of angiographic coronary artery disease (CAD).
  
  
  METHODS
  We measured epicardial fat thickness by computed tomography and assessed the presence and extent of CAD by coronary angiography in participants from the prospective EVASCAN study. The association of EAT thickness with cardiovascular risk factors, coronary artery calcification scoring and angiographic CAD was assessed using multivariate regression analysis.
  
  
  RESULTS
  Of 970 patients (age 60.9 years, 71% male), 75% (n = 731) had CAD. Patients with angiographic CAD had thicker EAT on the left ventricle lateral wall when compared with patients without CAD (2.74±2.4 mm vs. 2.08±2.1 mm; p = 0.0001). The adjusted odds ratio (OR) for a patient with a LVLW EAT value ≥2.8 mm to have CAD was OR = 1.46 [1.03-2.08], p = 0.0326 after adjusting for risk factors. EAT also correlated with the number of diseased vessels (p = 0.0001 for trend). By receiver operating characteristic curve analysis, an EAT value ≥2.8 mm best predicted the presence of>50% diameter coronary artery stenosis, with a sensitivity and specificity of 46.1% and 66.5% respectively (AUC:0.58). Coronary artery calcium scoring had an AUC of 0.76.
  
  
  CONCLUSIONS
  Although left ventricle lateral wall EAT thickness correlated with the presence and extent of angiographic CAD, it has a low performance for the diagnosis of CAD.
authors.affiliation: Cardiology Department, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, Université Paris-Diderot, Sorbonne-Paris Cité, Paris, France.
authors.forename: Fabien A
authors.initials: FA
authors.lastname: Picard
authors.affiliation: Cardiology Department, Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Université Paris-Est-Créteil, Créteil, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Gueret
authors.affiliation: Radiology Department, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, Université Paris-Diderot, Sorbonne-Paris Cité, Paris, France; Département Hospitalo-Universitaire FIRE, INSERM U-1148, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, Université Paris-Diderot, Sorbonne-Paris Cité, Paris, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Laissy
authors.affiliation: Cardiology Department, Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Université Paris-Est-Créteil, Créteil, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Champagne
authors.affiliation: Cardiology Department, Centre Hospitalier Universitaire Arnaud de Villeneuve, Montpellier, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Leclercq
authors.affiliation: Cardiology Department, Centre Hospitalier Universitaire de Rangueil, Toulouse, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Carrié
authors.affiliation: Cardiology Department, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, Université Paris-Diderot, Sorbonne-Paris Cité, Paris, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Juliard
authors.affiliation: Cardiology Department, Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisière, Université Paris-Diderot, Sorbonne-Paris Cité, Paris, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Henry
authors.affiliation: Epidemiology and Clinical Research Unit, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Paris, France; Unité INSERM Centre D'investigation Épidémiologique 4, Paris, France.
authors.forename: Ralph
authors.initials: R
authors.lastname: Niarra
authors.affiliation: Epidemiology and Clinical Research Unit, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Paris, France; Unité INSERM Centre D'investigation Épidémiologique 4, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Chatellier
authors.affiliation: Cardiology Department, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, Université Paris-Diderot, Sorbonne-Paris Cité, Paris, France; Département Hospitalo-Universitaire FIRE, INSERM U-1148, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, Université Paris-Diderot, Sorbonne-Paris Cité, Paris, France; NHLI Imperial College, ICMS Royal Brompton Hospital, London, United Kingdom.
authors.forename: Philippe Gabriel
authors.initials: PG
authors.lastname: Steg
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging / Q000502:physiology*; D000368:Aged; D019540:Area Under Curve; D015992:Body Mass Index; D002118:Calcium / Q000378:metabolism; D002637:Chest Pain; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D003331:Coronary Vessels / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000502:physiology; D011446:Prospective Studies; D012372:ROC Curve; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D055105:Waist Circumference
chemical_list: D002118:Calcium