Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jul 20:19:100711.
doi: 10.1016/j.ajpc.2024.100711. eCollection 2024 Sep.

Relationship between epicardial adipose tissue and coronary atherosclerosis by CCTA in young adults (18-45)

Annalisa Filtz  1   2 , Daniel Lorenzatti  1 , Andrea Scotti  1 , Pamela Piña  1   3 , Carol Fernandez-Hazim  1 , Dou Huang  1 , Paul Ippolito  1 , John P Skendelas  1 , Toshiki Kuno  1 , Carlos J Rodriguez  1 , Aldo L Schenone  1 , Azeem Latib  1 , Carl J Lavie  4 , Leslee J Shaw  5 , Ron Blankstein  6 , Michael D Shapiro  7 , Mario J Garcia  1 , Daniel S Berman  8 , Damini Dey  8 , Salim S Virani  9 , Leandro Slipczuk  1
Affiliations

Relationship between epicardial adipose tissue and coronary atherosclerosis by CCTA in young adults (18-45)

Annalisa Filtz et al. Am J Prev Cardiol. .

Abstract

Objective: Epicardial adipose tissue (EAT) is implicated in the pathogenesis and progression of coronary artery disease (CAD). Limited data exists on the interplay between EAT and atherosclerosis in young individuals. Our study aims to explore the relationship between EAT and CAD in a young cohort.

Methods: All young (18-45 years) patients without prior CAD, referred for coronary computed tomography angiography (CCTA) from 2016 to 2022 were included. EAT volume and coronary artery calcium (CAC) were calculated from dedicated non-contrast scans. Coronary plaque presence, extent, and volume were quantified from CCTA. Multivariable logistic regression models for the presence of CAD, defined as any coronary atherosclerosis, were performed.

Results: Overall, 712 patients (39±4.8 years, 54 % female) with 45 % Hispanic, and 21 % non-Hispanic Black were included. Patients with CAD had higher EAT volume than those without (80.80 mL ± 36.00 vs 55.16 mL ± 27.92; P < 0.001). In those with CAC=0, higher EAT was associated with the presence of CAD compared to lower EAT volume (P < 0.001). An EAT volume >76 mL was associated with higher CAC (P < 0.001), segment involvement score (P < 0.001), and quantitative total, non-calcified, and low-attenuation plaque volumes (P < 0.002). At multivariable analysis, EAT volume (per 10 mL, OR: 1.21; 95 %CI: 1.12-1.30; P < 0.0001) was independently associated with the presence of CAD.

Conclusion: In a diverse cohort of young adults without history of CAD and undergoing a clinically indicated CCTA, EAT volume was independently associated with the presence of CAD. Our findings highlight EAT potential as a novel marker for CAD risk-assessment and a potential therapeutic target in young patients.

Keywords: CCTA; Coronary plaque; Epicardial adipose tissue; Young adults.

PubMed Disclaimer

Conflict of interest statement

Annalisa Filtz, Daniel Lorenzatti, and Leandro Slipczuk are supported by institutional grants from Amgen and Philips. Damini Dey received grant support from the 10.13039/100000050National Heart, Lung, and Blood Institute, software royalties from Cedars-Sinai Medical Center, and hold a patent (US8885905B2in USA and WO patent WO2011069120A1, Method and System for Plaque Characterization). Dr Lavie is a Consultant and Promotional Speaker for Amgen, a consultant to Novartis, and on a DSMB for NovoNordisk. Michael Shapiro reports grants (to institution) from PCORI, DCRI, Amgen, Boehringer Ingelheim, 89 Bio, Esperion, Genentech, Novartis, Ionis, Merck, New Amsterdam; Scientific Advisory Boards with Amgen, Agepha, Ionis, Novartis, Precision BioScience, Novo Nordisk, New Amsterdam; and as a Consultant with Ionis, Novartis, Regeneron, Aidoc, Shanghai Pharma Biotherapeutics, Kaneka. Others have nothing to disclose.

Figures

Fig. 1
Fig. 1
Representative Coronary Computed Tomography (CCT) Images of Epicardial Adipose Tissue (A) and Coronary Artery Plaque (B) Quantification. Panel B shows on the left a straight MPR reconstruction of the mid-RCA artery; on the right a plaque characterization showing lumen (in blue) with a 55 % diameter stenosis, and high burden of both noncalcified plaque (in red) and low-attenuation plaque (in orange). MPR, multiplanar reconstruction; RCA, right coronary artery.
Fig. 2
Fig. 2
Association Between Epicardial Adipose Tissue and Sex (B), or Coronary Artery Disease (B). The curves show density plots: on the X axis represents the EAT volume (mL), on the Y axis the density, expressed as a probability density function. CAD, coronary artery disease; EAT, epicardial adipose tissue.
Fig. 3
Fig. 3
Subgroup Analyses of Coronary Artery Disease per EAT Volume. Odds Ratios and P values for interaction are adjusted for: sex, age, BMI, hypertension, hyperlipidemia, and family history of CAD. BMI, body mass index; CAD, coronary artery disease; EAT, epicardial adipose tissue.
Central Illustration
Central Illustration
Epicardial Adipose Tissue and CAD by CCTA in Young Adults (18–45). (Top Left) Association between epicardial adipose tissue and coronary artery disease. (Top Right) Relationship between epicardial adipose tissue and coronary artery disease in CAC=0 population. (Bottom left) Coronary artery plaque characterization by epicardial adipose tissue volume. (Bottom right) Multivariable logistic regression analysis on coronary artery disease. BMI, body mass index; CAD, coronary artery disease; EAT, epicardial adipose tissue; LAP, low-attenuation plaque; CP, calcified plaque; NCP, non-calcified plaque; TP, total plaque.
See this image and copyright information in PMC

References

    1. Rallidis L.S., Xenogiannis I., Brilakis E.S., Bhatt D.L. Causes, angiographic characteristics, and management of premature myocardial infarction. J Am Coll Cardiol. 2022;79:2431–2449. - PubMed
    1. Stone N.J., Smith S.C., Orringer C.E., et al. Managing atherosclerotic cardiovascular risk in young adults: JACC state-of-the-art review. J Am Coll Cardiol. 2022;79:819–836. - PubMed
    1. Singh A., Collins B.L., Gupta A., et al. Cardiovascular risk and statin eligibility of young adults after an MI: partners YOUNG-MI registry. J Am Coll Cardiol. 2018;71:292–302. - PMC - PubMed
    1. Ichikawa K., Susarla S., Budoff M.J. The use of coronary artery calcium scoring in young adults. J Cardiovasc Comput Tomogr. 2023;17:242–247. - PMC - PubMed
    1. Sama C., Abdelhaleem A., Velu D., et al. Non-calcified plaque in asymptomatic patients with zero coronary artery calcium score: a systematic review and meta-analysis. J Cardiovasc Comput Tomogr. 2023;S1934-5925(23) 00438–0. - PubMed

LinkOut - more resources