title: Epicardial adipose tissue and cardiovascular outcome in patients with acute coronary syndrome undergoing percutaneous coronary intervention.
abstract: OBJECTIVE
  We investigated the association between epicardial adipose tissue (EAT) thickness and cardiovascular outcomes in a cohort of high-risk patients with acute coronary syndrome undergoing percutaneous coronary intervention.
  
  
  METHODS
  Of 1198 patients undergoing percutaneous coronary intervention, transthoracic echocardiography was performed in 438 patients during the index hospitalization. EAT thickness was measured in the parasternal long-axis view perpendicularly on the free wall of the right ventricle at end-systole in three consecutive cardiac cycles and then averaged. As the primary outcome measure, a composite of major adverse cardiovascular events - including cardiovascular death, non-fatal myocardial infarction and non-fatal stroke - was investigated after three years of follow-up.
  
  
  RESULTS
  Patients were included between 2004 and 2012 and 293 (66.9%) were men. The median EAT thickness was 2.65 mm (interquartile range 2.00-3.00). EAT was correlated with body mass index ( R=0.404; p<0.001), weight ( R=0.314; p<0.001), baseline creatinine ( R=0.118; p=0.014) and baseline glucose ( R=0.129; p=0.007). After a follow-up period of three years, a major adverse cardiovascular event occurred in 64 patients (14.6%) corresponding to 36 (8.2%) with cardiovascular death, 21 (4.8%) with myocardial infarction and seven (1.6%) with stroke. Regarding the primary endpoint, EAT thickness revealed a significant predictive effect on univariate Cox regression (hazards ratio 1.479, 95% CI 1.192-1.953; p=0.006) and multivariate Cox regression analysis (hazards ratio 1.524, 95% CI 1.011-2.267; p=0.038) after adjusting for established cardiovascular confounders.
  
  
  CONCLUSIONS
  In a cohort of high-risk patients with acute coronary syndrome undergoing percutaneous coronary intervention, EAT was associated with established markers of cardiovascular death and had a predictive value for the three-year cardiovascular outcome.
authors.affiliation: 1 3rd Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Austria.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Tscharre
authors.affiliation: 1 3rd Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Austria.
authors.forename: Christina
authors.initials: C
authors.lastname: Hauser
authors.affiliation: 1 3rd Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Austria.
authors.forename: Miklos
authors.initials: M
authors.lastname: Rohla
authors.affiliation: 1 3rd Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Austria.
authors.forename: Matthias K
authors.initials: MK
authors.lastname: Freynhofer
authors.affiliation: 2 Department for Internal Medicine II (Cardiology), Medical University of Vienna, Austria.
authors.forename: Johann
authors.initials: J
authors.lastname: Wojta
authors.affiliation: 1 3rd Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Austria.|3 Sigmund Freud University, Medical School, Austria.
authors.forename: Kurt
authors.initials: K
authors.lastname: Huber
authors.affiliation: 1 3rd Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Austria.|3 Sigmund Freud University, Medical School, Austria.
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Weiss
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D000273:Adipose Tissue / Q000000981:diagnostic imaging*; D001317:Austria / Q000453:epidemiology; D015992:Body Mass Index; D017023:Coronary Angiography; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D010496:Pericardium / Q000000981:diagnostic imaging*; D057234:Preoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
keywords: Epicardial adipose tissue; acute coronary syndrome; percutaneous coronary intervention