The thickness of epicardial adipose tissue (EAT) was reported to be highly associated with the incidence and severity of atrial fibrillation (AF). This study was conducted to analyze the ability of EAT thickness in predicting adverse cardiovascular (CV) events in AF.In 190 persistent AF patients, we performed a comprehensive transthoracic echocardiographic examination with assessment of EAT thickness. The definition of CV events included CV mortality, hospitalization for heart failure, myocardial infarction, and stroke.There were 69 CV events including 19 CV deaths, 32 hospitalizations for heart failure, 3 myocardial infarctions, and 15 strokes during a mean follow-up of 29 (25th–75th percentile: 17–36) months. The multivariable analysis demonstrates that chronic heart failure, increased left ventricular (LV) mass index and the ratio of transmitral E-wave velocity to early diastolic mitral annulus velocity, decreased body mass index, and increased EAT thickness (per 1-mm increase, odds ratio 1.224, 95% confidence interval [CI] 1.096–1.368, P < 0.001) were associated with adverse CV events. Additionally, the addition of EAT thickness to a model containing CHA2DS2-VASc score, left atrial volume index, and LV systolic and diastolic function significantly improved the values in predicting CV events (global χ2 increase 14.65, P < 0.001 and integrated discrimination improvement 0.10, 95% CI 0.04–0.16, P < 0.001).In AF, EAT thickness was useful in predicting adverse CV events. Additionally, EAT thickness could provide incremental value for CV outcome prediction over traditional clinical and echocardiographic parameters in AF.

Myocardial infarction (MI) occurs as the result of complex interactions of multiple genetic and environmental factors. By conducting a genome wide association study in a Japanese population using 210 785 single nucleotide polymorphism (SNP) markers, we identified a novel susceptible locus for MI on chromosome 5p15.3. An SNP (rs11748327) in this locus showed significant association in several independent cohorts (combined P¼5.3Â10 À13 , odds ratio¼0.80, comparison of allele frequency). Association study using tag SNPs in the same linkage disequilibrium block revealed that two additional SNPs (rs490556 and rs521660) conferred risk of MI. These findings indicate that the SNPs on chromosome 5p15.3 are novel protective genetic factors against MI. Keywords: association; genome; myocardial infarction; SNP INTRODUCTIONMyocardial infarction (MI) leads to principal cause of death in developed countries. MI is characterized by the rapid development of coronary thrombosis following atherosclerotic plaque instability, 1 which leads to necrosis of myocardium and might result in sudden death. Despite the change in lifestyle and recent development of biomarkers, pharmacological intervention and percutaneous coronary intervention using drug eluting stents, the mortality is still high.We started genome wide association studies (GWAS) of this disorder using nearly 90 000 gene-based single nucleotide polymorphisms (SNPs) (http://snp.ims.u-tokyo.ac.jp/) 2 by high-throughput multiplex-PCR invader assay system, 3 and identified several genes conferring risk of MI including LTA. [4][5][6] Although the roles of these susceptible genes in MI pathogenesis are under investigation, these findings showed the potent power of GWAS, which is hypothesis free, to identify unexpected anchors to further understand the disease. Through examining the LTA cascade by combination of biological and genetic analyses, we have identified additional MI susceptible genes. [7][8][9] Genetic variants that confer susceptibility to MI have been indicated to be present on several chromosomal loci. [10][11][12][13][14][15][16][17] These studies, however, were conducted in individuals from European decent. Therefore, we carried out a systematic GWAS using 210 785 SNPs for MI in Japanese population. We report here identification of SNPs on chromosome 5p15.3 as a novel protective genetic factor against MI. We also examined Taiwanese population to see its universality in another population. MATERIALS AND METHODS DNA samplesFor the genome wide association study and subsequent second-stage screening, MI case and control subjects (mixed cases with other diseases including asthma, breast cancer, lung cancer, hyperthyroidism, osteoporosis, chronic obstructive pulmonary disease, pollinosis and atopic dermatitis) were obtained from the BioBank Japan project (http://biobankjp.org/). The characteristics of the third, fourth cohorts and the diagnosis of define MI has been described previously. 8,9 For Taiwanese population, subjects were recruited from the Kaohsiung Medical Unive...