Incremental diagnostic value of epicardial adipose tissue for the detection of functionally relevant coronary artery disease.

Abstract:

BACKGROUND AND AIM:To determine the incremental diagnostic value of epicardial adipose tissue (EAT) volume in addition to the coronary artery calcium (CAC) score for detecting hemodynamic significant coronary artery disease (CAD). METHODS AND RESULTS:122 patients (mean age 61 ± 10 years, 61% male) without a previous cardiac history underwent a non-contrast CT scan for calcium scoring and EAT volume measurements. Subsequently all patients underwent invasive coronary angiography (ICA) in conjunction with fractional flow reserve (FFR) measurements. A stenosis >90% and/or a FFR ≤0.80 were considered significant. Mean EAT volume and CACscore were 128 ± 51 cm(3) and 418 ± 704, respectively. The correlation between EAT volume and the CACscore was poor (r = 0.11, p = 0.24). Male gender (odds ratio [OR] 2.86, p = 0.01), CACscore ([cut-off value 100] OR 3.31, p = 0.003, and EAT volume ([cut-off value 92 cm(3)] OR 4.28, p = 0.01) were associated with flow-limiting disease. The multivariate model revealed that only male gender (OR 2.50, p = 0.045), CAC score (OR 3.60, p = 0.005), and EAT volume (OR 4.95, p = 0.02) were independent predictors of myocardial ischemia. Using the cut-off values of 100 (CAC score) and 92 cm(3) (EAT volume), sensitivity, specificity, negative predictive value, positive predictive value, and accuracy for detecting functionally relevant CAD as indicated by FFR were 71, 57, 77, 50 and 63% and 91, 29, 85, 44 and 52% for the CACscore and EAT volume, respectively. Adding EAT volume to the CAC score and cardiovascular risk factors did not enhance diagnostic performance for the detection of significant CAD (p = 0.57). CONCLUSION:EAT volume measurements have no diagnostic value beyond calcium scoring and cardiovascular risk factors in the detection of hemodynamic significant CAD.

journal_name

Atherosclerosis

journal_title

Atherosclerosis

authors

Romijn MA,Danad I,Bakkum MJ,Stuijfzand WJ,Tulevski II,Somsen GA,Lammertsma AA,van Kuijk C,van de Ven PM,Min JK,Leipsic J,van Rossum AC,Raijmakers PG,Knaapen P

doi

10.1016/j.atherosclerosis.2015.07.005

subject

Has Abstract

pub_date

2015-09-01 00:00:00

pages

161-6

issue

1

eissn

0021-9150

issn

1879-1484

pii

S0021-9150(15)30025-3

journal_volume

242

pub_type

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