Association between epicardial adipose tissue and adverse outcomes in coronary heart disease patients with percutaneous coronary intervention

Abstract

We assessed the relationship between the volume of epicardial adipose tissue and long-term outcomes in patients with coronary heart disease (CHD) undergoing percutaneous coronary intervention (PCI). The patients with CHD were followed for at least 2 years after PCI. The epicardial adipose tissue volume (EATV) was measured using multi-slice computed tomography. Cox regression analysis was used to examine the relationship between EATV and clinical outcome. In this study, 500 patients were enrolled and followed up for a median of 25.2 months. The incidence of adverse cardiovascular events was 12.4%. No significant differences were observed in age, sex, proportion of patients with hypertension or diabetes, smoking, drinking, total cholesterol, triglyceride, high-density lipoprotein, or unstable angina pectoris among different EATV quartiles (P>0.05). The EATV was associated with body mass index (P<0.0001), low-density lipoprotein level (P=0.039), high-sensitivity C-reactive protein level (P<0.001), uric acid level (P=0.004), adiponectin level (P<0.001), and left ventricular ejection fraction (P<0.001). Kaplan–Meier analysis indicated a significant difference in survival rate of patients in EATV quartile 1 versus 4 (P=0.019). After adjusting for confounding factors, EATV quartile 4 (>216.15 cm3) was still associated with adverse cardiovascular outcomes (HR = 1.98, 95% CI: 1.15–4.47, P=0.023) compared with quartile 1 (<101.58 cm3). Our data suggest that EATV is an independent predictor of long-term major adverse cardiovascular events in CHD patients after PCI. Therefore, assessment of EATV using multi-slice computed tomography may contribute to risk stratification in these patients.

The Value of Epicardial Adipose Tissue for the Patients Treated with Percutaneous Coronary Intervention: A Systemic Review and Meta-analysis

“…The other 4 studies solely showed the relationship between EAT and ISR of patients treated with PCI [9][10][11][12]. The impact of EAT on MACEs for patients treated PCI was evaluated in other 2 studies [4,5]. Two studies lonely measured the in uence of EAT on no-re ow of patients with STEMI treated with primary PCI [15,17].…”

“…Accumulating evidences suggest that the prognostic value of epicardial adipose tissue (EAT) on no-re ow, ISR, infarct size and MACE for the patients treated with PCI [4,5]. previous meta-analysis has been demonstrated that elevated location-speci c EAT thickness at the left atrioventricular groove is associated with obstructive coronary artery disease [6].…”

“…By autocrine and paracrine means, it generates various types of anti-/proin ammatory mediators and free fatty acids [8]. More recently, multiple clinical researches have shown that increased EAT deposition plays a pivotal role in the development and progression of ISR [9][10][11][12][13][14], no-re ow [15][16][17][18], infarct size [19,20] or MACE [4,5,13,14] for patients treated with PCI with inconsistent results.…”

“…The relationship between EAT and ischemic heart disease might be complex biphasic [21,22]. Some studies have demonstrated that relationship between larger EAT volume, increased release of in ammatory molecules, and more advanced stages of coronary heart disease [4,5,13,14]. However, patients with cardiomyopathy with left ventricular ejection fraction < 35% had apparently smaller EAT volume in comparison with healthy controls [22,23].…”

Tai Chi Improves Coronary Heart Disease Risk by Inactivating MAPK/ERK Pathway through Serum miR‐126

“…Epicardial fat is visceral thoracic fat and known to be related to the presence of dyslipidemia and coronary arterial stenosis in the patients after PCI [14]. Epicardial adipose tissue volume (EATV) is an independent indicator of long-term main adverse cardiovascular events in CHD patients after PCI [15] and affected by adipose tissue dysfunction. HR variability is also influenced by epicardial fat [16].…”