title: Increased epicardial adipose tissue is associated with coronary artery disease and major adverse cardiovascular events.
abstract: BACKGROUND
  Increased-epicardial-adipose tissue (EAT) is associated with the presence and severity of subclinical-atherosclerosis. This study investigates the long-term clinical-outcome of subjects with and without increased-EAT.
  
  
  METHODS
  Two hundred and forty-five subjects, aged 61 ± 9 years and 34% women underwent clinically-indicated computed-tomography-angiography (CTA), and body-surface-area adjusted EAT was measured and were followed prospectively. CTA-diagnosed coronary-artery-disease (CAD) was defined as obstructive (luminal-stenosis ≥ 50%), non-obstructive (luminal-stenosis: 1-49%) and zero-obstruction. Major-adverse-cardiac-event (MACE) was defined as myocardial-infarction or cardiovascular-death.
  
  
  RESULTS
  EAT increased significantly from subjects with zero-obstruction-coronaries (93 ± 37 cm(3)/m(2)) to non-obstructive-CAD (132 ± 25 cm(3)/m(2)) to obstructive-CAD (145 ± 35 cm(3)/m(2)) (P = 0.01). During the 48-month follow-up, the event-rate was 8.6% (21). The event free survival-rate decreased significantly from 99% in the lowest-quartile to 86.6% in the highest-quartile of EAT. After adjustment for risk-factors, the hazard ratio of MACE was 1.4, 3.1 and 5.7 in lower mid-, upper mid- and highest-quartiles of EAT as compared to lowest-quartile of EAT (P < 0.05).
  
  
  CONCLUSIONS
  Increased EAT is directly associated with CAD and predicts MACE independent of the age, gender and conventional-risk-factors.
authors.affiliation: David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA. Electronic address: drfsadeghi@gmail.com.
authors.forename: Fereshteh
authors.initials: F
authors.lastname: Hajsadeghi
authors.affiliation: David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
authors.forename: Vahid
authors.initials: V
authors.lastname: Nabavi
authors.affiliation: David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
authors.forename: Ajay
authors.initials: A
authors.lastname: Bhandari
authors.affiliation: David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Choi
authors.affiliation: David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
authors.forename: Hunter
authors.initials: H
authors.lastname: Vincent
authors.affiliation: David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Flores
authors.affiliation: David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Budoff
authors.affiliation: David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
authors.forename: Naser
authors.initials: N
authors.lastname: Ahmadi
mesh_terms: D000273:Adipose Tissue / Q000473:pathology*; D000368:Aged; D002318:Cardiovascular Diseases / Q000473:pathology; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology; D010496:Pericardium / Q000473:pathology*; D016016:Proportional Hazards Models; D012372:ROC Curve; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012907:Smoking; D014057:Tomography, X-Ray Computed
keywords: Computed tomography angiography (CTA); Coronary artery disease (CAD); Epicardial adipose tissue (EAT); Major adverse cardiac event (MACE)