title: Echocardiographic epicardial fat thickness is a predictor for target vessel revascularization in patients with ST-elevation myocardial infarction.
abstract: BACKGROUND
  The amount of epicardial adipose tissue (EAT) has been demonstrated to correlate with the severity of coronary artery disease (CAD) and the CAD activity. The aim of this study is to assess the impact of EAT on long term clinical outcomes in patients with ST elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI).
  
  
  METHODS
  We analyzed the data and clinical outcomes of 761 patients (614 males, 57 ± 12 year-old) with STEMI who underwent successful primary PCI from 2003 to 2009. All patients were divided into two groups: thick EAT group, EAT ≥ 3.5 mm and thin EAT group, EAT < 3.5 mm. The primary end points were all-cause death, recurrent MI, target vessel revascularization (TVR) and major cardiac adverse events (MACEs), composite of all-cause death, recurrent MI and TVR, within 5 years.
  
  
  RESULTS
  Median and mean EAT of 761 patients were 3.3 mm and 3.6 ± 1.7 mm, respectively. Mean follow up period was 46 ± 18 months. MACE-free survival rate in the thick EAT group was significantly lower than in the thin EAT group (log-rank P = 0.001). The event-free survival rate of all-cause death of the thick EAT group was significantly lower than that of the thin EAT group (log-rank P = 0.005). The TVR-free survival rate in the thick EAT group was significantly lower than in the thin EAT group (log-rank P = 0.007). The event-free survival rate of recurrent MI were not significantly different between the groups (log-rank P = 0.206). In the Cox's proportional hazard model, the adjusted hazard ratio of thick EAT thickness for TVR was 1.868 (95% confidence interval 1.181-2.953, P = 0.008).
  
  
  CONCLUSIONS
  This study demonstrates that the EAT thickness is related with long term clinical outcome in patients with STEMI. The EAT thickness might provide additional information for future clinical outcome, especially TVR.
authors.affiliation: Department of Cardiology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Korea.
authors.forename: Jin-Sun
authors.initials: JS
authors.lastname: Park
authors.affiliation: Department of Cardiology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Korea.
authors.forename: You-Hong
authors.initials: YH
authors.lastname: Lee
authors.affiliation: Department of Cardiology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Korea.
authors.forename: Kyoung-Woo
authors.initials: KW
authors.lastname: Seo
authors.affiliation: Department of Cardiology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Korea.
authors.forename: Byoung-Joo
authors.initials: BJ
authors.lastname: Choi
authors.affiliation: Department of Cardiology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Korea.
authors.forename: So-Yeon
authors.initials: SY
authors.lastname: Choi
authors.affiliation: Department of Cardiology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Korea.
authors.forename: Myeong-Ho
authors.initials: MH
authors.lastname: Yoon
authors.affiliation: Department of Cardiology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Korea.
authors.forename: Gyo-Seung
authors.initials: GS
authors.lastname: Hwang
authors.affiliation: Department of Cardiology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Korea.
authors.forename: Seung-Jea
authors.initials: SJ
authors.lastname: Tahk
authors.affiliation: Department of Cardiology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Korea. shinjh@ajou.ac.kr.
authors.forename: Joon-Han
authors.initials: JH
authors.lastname: Shin
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging* / Q000473:pathology; D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D010496:Pericardium / Q000000981:diagnostic imaging* / Q000473:pathology; D016016:Proportional Hazards Models; D000072657:ST Elevation Myocardial Infarction / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Epicardial adipose tissue; Myocardial Infarction; Prognosis