title: Increased Epicardial Fat Thickness in Sudden Death From Stable Coronary Artery Atherosclerosis.
abstract: BACKGROUND
  Sudden death from stable coronary artery atherosclerosis (SCAA) is well recognized. However, individuals can have ischemic heart disease or coronary artery atherosclerosis but die of noncardiac causes. Recently, it has been recognized that increased epicardial fat is detrimental to normal heart function. We hypothesize that individuals who die of SCAA have increased epicardial fat.
  
  
  OBJECTIVE
  The aim of this study was to investigate whether there is an increase in epicardial fat in individuals who suddenly died of SCAA.
  
  
  METHODS
  This was a 1-year retrospective study comparing the average epicardial fat thickness using postmortem computed tomography scan between individuals who suddenly died of SCAA (SCAA group) with individuals who primarily died of natural noncardiac causes but had established ischemic heart disease or significant coronary artery atherosclerosis (NCC group).
  
  
  RESULTS
  Average epicardial fat thickness was significantly higher in the SCAA group (8 ± 2 mm) than in the NCC group (6 ± 2 mm, P = 0.008).
  
  
  CONCLUSIONS
  Individuals who die of SCAA appear to have higher epicardial fat thickness. The increase in epicardial fat may have an additional detrimental effect to the heart predisposing sudden death in individuals with coronary artery atherosclerosis.
authors.affiliation: From the *Department of Forensic Medicine, Newcastle, Forensic & Analytical Science Service, New South Wales Health Pathology, John Hunter Hospital, Newcastle, New South Wales; †Faculty of Education, Science, Technology and Mathematics (ESTeM), University of Canberra, Canberra, Australian Capital Territory; and ‡School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan; and §Blacktown Hospital, Blacktown, New South Wales, Australia.
authors.forename: Belinda
authors.initials: B
authors.lastname: Fuller
authors.forename: Jack
authors.initials: J
authors.lastname: Garland
authors.forename: Sravan
authors.initials: S
authors.lastname: Anne
authors.forename: Raymond
authors.initials: R
authors.lastname: Beh
authors.forename: Dennis
authors.initials: D
authors.lastname: McNevin
authors.forename: Rexson
authors.initials: R
authors.lastname: Tse
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000401:mortality*; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed