Association of Epicardial Adipose Tissue Thickness with Extent and Complexity of Coronary Artery Disease in Patients with Acute Coronary Syndrome

Abstract

Background: Epicardial adipose tissue (EAT) secretes proatherogenic and proinflammatory cytokines and affects cardiac morphology and functions. The aim of this study was to measure EAT thickness in patients without previous coronary artery disease (CAD) who were admitted with acute coronary syndrome (ACS), and determine its relationship to ACS clinical risk scores, and the severity and complexity of CAD. Methods: This study enrolled 150 patients (mean age 59.7 +/- 11.1 years, 83% men), including 75 with non-ST elevated myocardial infarction (NSTEMI group) and 75 with ST elevated myocardial infarction (STEMI group). Cardiovascular risk factors and laboratory analyses were recorded. The Global Registry of Acute Coronary Events (GRACE) risk score, TIMI clinical, SYNTAX and Gensini angiographic scores were calculated according to guidelines. EAT thickness was measured by echocardiography above the free wall of the right ventricle, perpendicular to the aortic annulus. Results: There were no significant differences in CAD risk factors, clinical, demographic features, anthropometric measurements, or EAT thickness (mean 5.94 +/- 1.17 mm) between the two groups. In the patients with ACS, there were no direct correlations between EAT thickness and TIMI, GRACE, SYNTAX and Gensini scores. There were positive and significant correlations between the thickness of EAT and SYNTAX (r = 0.243, p = 0.035) and Gensini (r = 0.394, p < 0.001) scores only in the NSTEMI group. Multivariate linear regression analysis showed that EAT predicted SYNTAX (beta = 0.06, p < 0.001) and Gensini (beta = 0.04, p = 0.006) scores, but not TIMI score (beta = 0.1, p = 0.06) in the patients overall. Conclusions: EAT thickness measured by 2D echocardiography was not correlated with the extent or complexity of CAD in the ACS patients. However, after adjusting for confounding factors, multivariate linear regression analysis showed that EAT predicted SYNTAX and Gensini scores in these patients.