Epicardial adipose tissue may predict new-onset atrial fibrillation in patients with ST-segment elevation myocardial infarction

Eren, Hayati; Omar, Muhammed Bahadır; Kaya, Ülker; Öcal, Lütfi; Yılmaz, Mehmet; Akkan, Sedat

doi:10.2459/jcm.0000000000001254

Cited by 11 publications

(22 citation statements)

References 26 publications

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“…The following variables, thought to be clinically relevant, were included in the PS model: age, body mass index, hypercholesterolemia, hypertension, Smoke status, diabetes, family history of premature coronary artery disease, prior MI, prior PCI or coronary bypass, anterior STEMI, shock at presentation, cardiac arrest at presentation, radial access, use of glycoprotein IIb/IIIa inhibitors, left main artery as infarcted related artery, multivessel disease, stent implantation, postprocedural TIMI flow grade = 3, symptom-to-balloon time, creatinine levels, LVEF. Posthoc interaction analyses between gender and the following variables were also performed: age, diabetes, anterior STEMI, symptoms-to-balloon time and multivessel disease 15,16 …”

Section: Methodsmentioning

confidence: 99%

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Female gender and mortality in ST-segment-elevation myocardial infarction treated with primary PCI

Paradossi

Taglieri

Massarelli

et al. 2022

Journal of Cardiovascular Medicine

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AimsTo investigate gender difference in mortality among patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous angioplasty (PPCI).MethodsWe analyzed data from the prospective registries of two hub PPCI centres over a 10-year period to assess the role of female gender as an independent predictor of both all-cause and cardiac death at 30 days and 1 year. To account for all confounding variables, a propensity score (PS)-adjusted multivariable Cox regression model and a PS-matched comparison between the male and female were used.ResultsAmong 4370 consecutive STEMI patients treated with PPCI at participating centres, 1188 (27.2%) were women. The survival rate at 30 days and 1 year were significantly lower in women (Log-rank P-value < 0.001). At PS-adjusted multivariable Cox regression analysis, female gender was independently associated with an increased risk of 30-day all-cause death [hazard ratio (HR) = 2.09; 95% confidence interval (CI): 1.45–3.01, P < 0.001], 30-day cardiac death (HR = 2.03;95% CI:1.41–2.93, P < 0.001), 1-year all-cause death (HR = 1.45; 95% CI:1.16–1.82, P < 0.001) and 1-year cardiac death (HR = 1.51; 95% CI:1.15–1.97, P < 0.001). For the study outcome, we found a significant interaction of gender with the multivessel disease in females who were at increased risk of mortality in comparison with men in absence of multivessel disease. After the PS matching procedure, a subset of 2074 patients were identified. Women still had a lower survival rate and survival free from cardiac death rate both at 30-day and at 1-year follow-up.ConclusionAs compared with men, women with STEMI treated with PPCI have higher risk of both all-cause death and cardiac mortality at 30-day and 1-year follow-up.

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Section: Methodsmentioning

confidence: 99%

“…Posthoc interaction analyses between gender and the following variables were also performed: age, diabetes, anterior STEMI, symptoms-toballoon time and multivessel disease. 15,16 We also evaluated the association between LVEF and gender by means of multiple linear regression adjusting for the PS.…”

Section: Introductionmentioning

confidence: 99%

Female gender and mortality in ST-segment-elevation myocardial infarction treated with primary PCI

Paradossi

Taglieri

Massarelli

et al. 2022

Journal of Cardiovascular Medicine

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“…Those with higher EAT quantifications had increased odds of MI (OR, 2.63 [95% CI, 1.39–4.96]; I 2 =74%; P =0.003) and coronary revascularization (OR, 2.99 [95% CI, 1.64–5.44]; I 2 =70%; P <0.001; Table 2). In addition, 3 studies 47–49 (n=1031) were included for the analysis of atrial fibrillation. Individuals with higher EAT quantifications had increased odds of developing atrial fibrillation (adjusted OR, 4.04 [95% CI, 3.06–5.32]; I 2 =0%; P <0.001).…”

Section: Resultsmentioning

confidence: 99%

“…For example, some included studies measured EAT thickness at endsystole, 32,41,42 while others measured it at end-diastole. 43,47 Some averaged EAT thickness values from multiple TTE views 41,46 while others only used a single view. 47,53 Several used the average thickness over 3 cardiac cycles 42,45 while others considered 10 cycles.…”

Section: Discussionmentioning

confidence: 99%

Epicardial Adipose Tissue Assessed by Computed Tomography and Echocardiography Are Associated With Adverse Cardiovascular Outcomes: A Systematic Review and Meta-Analysis

Chong

Jayabaskaran

Ruban

et al. 2023

Circ: Cardiovascular Imaging

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Background: Epicardial adipose tissue (EAT) has garnered attention as a prognostic and risk stratification factor for cardiovascular disease. This study, via meta-analyses, evaluates the associations between EAT and cardiovascular outcomes stratified across imaging modalities, ethnic groups, and study protocols. Methods: Medline and Embase databases were searched without date restriction on May 2022 for articles that examined EAT and cardiovascular outcomes. The inclusion criteria were (1) studies measuring EAT of adult patients at baseline and (2) reporting follow-up data on study outcomes of interest. The primary study outcome was major adverse cardiovascular events. Secondary study outcomes included cardiac death, myocardial infarction, coronary revascularization, and atrial fibrillation. Results: Twenty-nine articles published between 2012 and 2022, comprising 19 709 patients, were included in our analysis. Increased EAT thickness and volume were associated with higher risks of cardiac death (odds ratio, 2.53 [95% CI, 1.17–5.44]; P =0.020; n=4), myocardial infarction (odds ratio, 2.63 [95% CI, 1.39–4.96]; P =0.003; n=5), coronary revascularization (odds ratio, 2.99 [95% CI, 1.64–5.44]; P <0.001; n=5), and atrial fibrillation (adjusted odds ratio, 4.04 [95% CI, 3.06–5.32]; P <0.001; n=3). For 1 unit increment in the continuous measure of EAT, computed tomography volumetric quantification (adjusted hazard ratio, 1.74 [95% CI, 1.42–2.13]; P <0.001) and echocardiographic thickness quantification (adjusted hazard ratio, 1.20 [95% CI, 1.09–1.32]; P <0.001) conferred an increased risk of major adverse cardiovascular events. Conclusions: The utility of EAT as an imaging biomarker for predicting and prognosticating cardiovascular disease is promising, with increased EAT thickness and volume being identified as independent predictors of major adverse cardiovascular events. Registration: URL: https://www.crd.york.ac.uk/prospero ; Unique identifier: CRD42022338075.

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“…Actually, numerous clinical and experimental studies in recent years have suggested that pericardial fat and atrial fibrosis are strongly associated with the incidence, maintenance and recurrence of atrial fibrillation in patients managed with the rhythm-control strategy 5,6 and also in patients with ischemic cardiomyopathy. 7 The heart is surrounded by a variable amount of perivisceral adipose tissue. 8 It consists of a paracardial component, placed outside of the visceral pericardium, and an epicardial component placed between the visceral pericardium and epicardium, and combined they make pericardial fat.…”

Section: Introductionmentioning

confidence: 99%

Correlation between epicardial adipose tissue and atrial fibrillation burden in coronary artery bypass graft surgery

Bolzan

Morani²,

Rizzati

et al. 2023

Journal of Cardiovascular Medicine

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Aims Recent studies suggest an association between epicardial adipose tissue (EAT) and atrial fibrillation. The aim of the study is to evaluate the quantitative and qualitative characteristics of EAT in relation to atrial fibrillation burden after coronary artery bypass graft (CABG).Methods This prospective single-centre study included patients undergoing CABG. The patients underwent transthoracic echocardiography and collection of a bioptic sample containing right appendage and EAT during CABG for histological characterization. After surgery, clinical and telemetry data were collected.Results Fifty-six consecutive patients were enrolled. The mean postsurgical hospitalization was 7.9 W 3.7 days. Twenty-two patients had at least one episode of atrial fibrillation. In the atrial fibrillation group, there was a bigger atrial volume, a higher degree of diastolic disfunction, a thicker layer of EAT and an older median age in comparison with the group that did not develop it. EAT with a cut-off of 4 mm was a predictor of atrial fibrillation with an odds ratio (OR) of 1.49 (confidence interval (CI) 1.09-2.04), 73% of sensibility and 89% of specificity. From the histological analyses, the patients with atrial fibrillation had a significantly higher percentage of fibrosis. At univariate analysis, atrial volume [OR 1.05, CI 1.01-1.09, P U 0.022], E/A rate (OR 0.04, CI 0.02-0.72 P U 0.29), the percentage of fibrosis (OR 1.12, CI 1.00-1.25, P U 0.045) and age (OR 1.17, CI 1.07-1.28, P U 0.001) were predictors of atrial fibrillation. At multivariate analysis, atrial volume (P U 0.027), fibrosis (P U 0.003) and age (P U 0.039) were independent predictors of atrial fibrillation. ConclusionPostcardiac surgical atrial fibrillation is frequent. EAT thickness, atrial volume, fibrosis and age are predictors of postcardiac surgical atrial fibrillation.

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Epicardial adipose tissue may predict new-onset atrial fibrillation in patients with ST-segment elevation myocardial infarction

Cited by 11 publications

References 26 publications

Female gender and mortality in ST-segment-elevation myocardial infarction treated with primary PCI

Female gender and mortality in ST-segment-elevation myocardial infarction treated with primary PCI

Epicardial Adipose Tissue Assessed by Computed Tomography and Echocardiography Are Associated With Adverse Cardiovascular Outcomes: A Systematic Review and Meta-Analysis

Correlation between epicardial adipose tissue and atrial fibrillation burden in coronary artery bypass graft surgery

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