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

Abstract

BackgroundAccumulating evidences suggest that the prognostic value of epicardial adipose tissue (EAT) on no-reflow, in-stent restenosis (ISR), infarct size, and main adverse cardiovascular events (MACE) for the patients treated with percutaneous coronary intervention (PCI). The relationship between EAT and outcomes of patients underwent PCI is still partly elusive. MethodsTo elucidate the relationship in detail, we searched PubMed, web of science, and the Cochrane Library for studies evaluating the association of EAT and patients treated with PCI. Thirteen studies enrolling 3683 patients were eventually include in our systemic review and meta-analysis. ResultsThe EAT measured by thickness or volume was significantly higher in the ISR group compared to those in the non-ISR group (The standard mean difference -0.34, 95% CI, -0.49, -0.18, p <0.0001; I2 =36%). The incidence of no-reflow was significantly higher in thicker EAT group compared to thin EAT group (pooled relative ratio 1.52, 95%CI 1.29-1,80, p <0.0001; I2 =0%). Thicker EAT was significantly associated with MACEs (pooled relative ratio 1.50, 95% 1.18-1.90, p =0.008). A lower EAT volume is associated with larger infarct size in ST elevated myocardial infarction patients treated with primary PCI (standard mean difference was -5.45, 95% CI -8.10, -2.80; p <0.0001; I2 =0%). In summary, our systemic review and meta-analysis suggest that high EAT is related with a significant increased risk of non-reflow, MACE and decreased infarct size in patients with coronary artery disease treated with PCI. This paradox phenomenon demonstrates that the quality of EAT may play more important role than the solely thickness or volume of EAT.