title: Pericardial fat is associated with all-cause mortality but not incident CVD: the Rancho Bernardo Study.
abstract: OBJECTIVE
  Pericardial and intra-thoracic fat are associated with prevalent cardiovascular disease (CVD) and CVD risk factors. However, it is unclear if these fat depots predict incident CVD events and/or all-cause mortality. We examined prospective associations between areas of pericardial and intra-thoracic fat and incident CVD and mortality over a 12-year follow-up in a subset of participants without baseline clinical CVD from the Rancho Bernardo Study (RBS).
  
  
  METHODS
  Participants were 343 community-dwelling older adults (mean baseline age = 67) who completed a clinic visit in 2001-02, including a computed tomography scan of the chest. Incident CVD and mortality were recorded through January 2013.
  
  
  RESULTS
  Over a 12.6-year median follow-up, there were 60 incident CVD events and 49 deaths. Pericardial fat was associated with all-cause mortality, such that each standard deviation increment predicted a 34% higher chance of death after adjusting for demographics, lifestyle factors, comorbidities, and visceral fat (95% CI = 1.01-1.78). When categorized by tertile, those in the middle tertile of pericardial fat showed no increased risk of mortality, while those in the highest tertile had 2.6 times the risk (95% CI = 1.10-5.97) compared to the lowest tertile. There was a marginal association between intra-thoracic fat and mortality (p = 0.06). Neither pericardial nor intra-thoracic fat was significantly associated with incident CVD. There were no significant interactions by sex.
  
  
  CONCLUSIONS
  Higher pericardial, but not intra-thoracic, fat was associated with earlier all-cause mortality in older adults over a 12-year follow-up. This association was primarily driven by a higher mortality rate in those in the highest tertile of pericardial fat.
authors.affiliation: Division of Behavioral Medicine, Department of Family and Preventive Medicine, University of California, San Diego, USA. Electronic address: blarsen@ucsd.edu.
authors.forename: Britta A
authors.initials: BA
authors.lastname: Larsen
authors.affiliation: Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego, USA.
authors.forename: Gail A
authors.initials: GA
authors.lastname: Laughlin
authors.affiliation: Division of Preventive Medicine, Department of Family and Preventive Medicine, University of California, San Diego, USA.
authors.forename: Sarah D
authors.initials: SD
authors.lastname: Saad
authors.affiliation: Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Barrett-Connor
authors.affiliation: Division of Preventive Medicine, Department of Family and Preventive Medicine, University of California, San Diego, USA.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Allison
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, USA.
authors.forename: Christina L
authors.initials: CL
authors.lastname: Wassel
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging*; D050154:Adiposity; D000368:Aged; D002140:California / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging* / Q000401:mortality*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed
keywords: All-cause mortality; Body composition; Fat distribution; Incident CVD; Intra-thoracic fat; Pericardial fat