Objective: Epicardial adipose tissue (EAT) is suggested to correlate with metabolic risk factors and to promote plaque
development in the coronary arteries. We sought to determine whether EAT thickness was associated or not with the
presence and extent of angiographic coronary artery disease (CAD).
Methods: We measured epicardial fat thickness by computed tomography and assessed the presence and extent of CAD by
coronary angiography in participants from the prospective EVASCAN study. The association of EAT thickness with
cardiovascular risk factors, coronary artery calcification scoring and angiographic CAD was assessed using multivariate
regression analysis.
Results: Of 970 patients (age 60.9 years, 71% male), 75% (n = 731) had CAD. Patients with angiographic CAD had thicker EAT
on the left ventricle lateral wall when compared with patients without CAD (2.7462.4 mm vs. 2.0862.1 mm; p = 0.0001).
The adjusted odds ratio (OR) for a patient with a LVLW EAT value $2.8 mm to have CAD was OR = 1.46 [1.03–2.08],
p = 0.0326 after adjusting for risk factors. EAT also correlated with the number of diseased vessels (p = 0.0001 for trend). By
receiver operating characteristic curve analysis, an EAT value $2.8 mm best predicted the presence of.50% diameter
coronary artery stenosis, with a sensitivity and specificity of 46.1% and 66.5% respectively (AUC:0.58). Coronary artery
calcium scoring had an AUC of 0.76.
Conclusion: Although left ventricle lateral wall EAT thickness correlated with the presence and extent of angiographic CAD,
it has a low performance for the diagnosis of CAD.