title: Epicardial Adipose Tissue Is Associated with Plaque Burden and Composition and Provides Incremental Value for the Prediction of Cardiac Outcome. A Clinical Cardiac Computed Tomography Angiography Study.
abstract: We sought to investigate the association of epicardial adipose tissue (eCAT) volume with plaque burden, circulating biomarkers and cardiac outcomes in patients with intermediate risk for coronary artery disease (CAD).
  
  
  
  177 consecutive outpatients at intermediate risk for CAD and completed biomarker analysis including high-sensitive Troponin T (hs-TnT) and hs-CRP underwent 256-slice cardiac computed tomography angiography (CCTA) between June 2008 and October 2011. Patients with lumen narrowing ≥50% exhibited significantly higher eCAT volume than patients without any CAD or lumen narrowing <50% (median (interquartile range, IQR): 108 (73-167) cm3 vs. 119 (82-196) cm3, p = 0.04). Multivariate regression analysis demonstrated an independent association eCAT volume with plaque burden by number of lesions (R2 = 0.22, rpartial = 0.29, p = 0.026) and CAD severity by lumen narrowing (R2 = 0.22, rpartial = 0.23, p = 0.038) after adjustment for age, diabetes mellitus, hyperlidipemia, body-mass-index (BMI), hs-CRP and hs-TnT. Univariate Cox proportional hazards regression analysis identified a significant association for both increased eCAT volume and maximal lumen narrowing with all cardiac events. Multivariate Cox proportional hazards regression analysis revealed an independent association of increased eCAT volume with all cardiac events after adjustment for age, >3 risk factors, presence of CAD, hs-CRP and hs-TnT.
  
  
  
  Epicardial adipose tissue volume is independently associated with plaque burden and maximum luminal narrowing by CCTA and may serve as an independent predictor for cardiac outcomes in patients at intermediate risk for CAD.
authors.affiliation: University of Heidelberg, Department of Cardiology, Heidelberg, Germany.
authors.forename: Gitsios
authors.initials: G
authors.lastname: Gitsioudis
authors.affiliation: University of Heidelberg, Department of Cardiology, Heidelberg, Germany.
authors.forename: Christina
authors.initials: C
authors.lastname: Schmahl
authors.affiliation: University of Heidelberg, Department of Cardiology, Heidelberg, Germany.
authors.forename: Anna
authors.initials: A
authors.lastname: Missiou
authors.affiliation: University of Heidelberg, Institute of Psychology, Heidelberg, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Voss
authors.affiliation: University of Heidelberg, Department of Cardiology, Heidelberg, Germany.
authors.forename: Alena
authors.initials: A
authors.lastname: Schüssler
authors.affiliation: University of Heidelberg, Department of Cardiology, Heidelberg, Germany.
authors.forename: Hassan
authors.initials: H
authors.lastname: Abdel-Aty
authors.affiliation: University of Heidelberg, Department of Cardiology, Heidelberg, Germany.
authors.forename: Sebastian J
authors.initials: SJ
authors.lastname: Buss
authors.affiliation: CT Clinical Science, Philips Healthcare GmbH, Hamburg, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Mueller
authors.affiliation: CT Clinical Science, Philips Healthcare, Cleveland, Ohio, United States of America.
authors.forename: Mani
authors.initials: M
authors.lastname: Vembar
authors.affiliation: University of Heidelberg, Department of Diagnostic and Interventional Radiology, Heidelberg, Germany.
authors.forename: Mark
authors.initials: M
authors.lastname: Bryant
authors.affiliation: University of Heidelberg, Department of Diagnostic and Interventional Radiology, Heidelberg, Germany.
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Kauczor
authors.affiliation: University of Heidelberg, Department of Cardiology, Heidelberg, Germany.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Giannitsis
authors.affiliation: University of Heidelberg, Department of Cardiology, Heidelberg, Germany.
authors.forename: Hugo A
authors.initials: HA
authors.lastname: Katus
authors.affiliation: University of Heidelberg, Department of Cardiology, Heidelberg, Germany.
authors.forename: Grigorios
authors.initials: G
authors.lastname: Korosoglou
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging / Q000473:pathology*; D000368:Aged; D015415:Biomarkers; D015897:Comorbidity; D000072226:Computed Tomography Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D010496:Pericardium / Q000473:pathology*; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging / Q000473:pathology*; D011159:Population Surveillance; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers