Relationship between epicardial adipose tissue and subclinical coronary artery disease in patients with extra-cardiac arterial disease

Objective Epicardial adipose tissue (EAT) and mediastinal adipose tissue (MAT) are linked to coronary artery disease (CAD). The association between EAT, MAT, and severity of CAD in known extra-cardiac arterial disease was investigated. Design and Methods Sixty-five cardiac asymptomatic patients (mean age 65 +/- 8 years, 69% male) with peripheral arterial disease, carotid stenosis, or aortic aneurysm underwent coronary computed tomography angiography. Patients were divided into non-significant (<50% stenosis, N = 35), single vessel (N = 15) and multi-vessel CAD (N = 15). EAT and MAT were quantified on computed tomography images using volumetric software. Results Subgroups did not significantly differ by age, gender, or cardiovascular risk factors. Median EAT was 99.5, 98.0, and 112.0 cm3 (P=0.38) and median MAT was 66.0, 90.0, and 81.0 cm3 (P=0.53) for non-significant, single vessel, and multi-vessel CAD, respectively. In age- and gender-adjusted analysis, only EAT was significantly associated with CAD (odds ratio [OR] 1.12 [95% confidence interval, 1.01-1.25] per 10 cm3 increase in EAT; P = 0.04). This remained in multivariate-adjusted analysis (OR 1.21 [1.04-1.39]; P=0.01). Conclusions In patients with known extra-cardiac arterial disease, CAD is correlated with EAT, but not with MAT. These results suggest that EAT has a local effect on coronary atherosclerosis, apart from the endocrine effect of visceral fat.