The purpose of this study was to examine the association of pericardial fat with the
presence of coronary plaques.
Waist circumference, reflecting abdominal obesity, is a risk factor of metabolic syndrome
and coronary artery disease (CAD). Adipose tissue secretes many factors implicated
in atherogenesis, however, the role of pericardial fat (ectopic visceral fat around
coronary arteries) in the pathogenesis of CAD is not clear.
We measured total pericardial fat volume (PFV) and determined presence and characteristics
of coronary plaques using 64-slice computed tomography in 171 consecutive patients
suspected of CAD (101 men; mean age, 66+/-11 years, +/-SD).
PFV correlated with age (p<0.05), body mass index (p<0.05), waist circumference (p<0.01),
and high-density lipoprotein cholesterol (p<0.01) by multivariate regression analysis.
PFV was significantly larger in patients with coronary plaques, even nonstenotic or
noncalcified ones, than those without plaques (any plaques, n=123; 201+/-71cm(3),
nonstenotic plaques, n=51; 192+/-63, noncalcified plaques, n=32; 196+/-56 vs. no plaque,
n=48; 144+/-45, p<0.001, respectively). Multivariate backward logistic regression
analysis demonstrated that PFV, but not waist circumference, significantly associated
with the presence of any coronary plaques (odds ratio [OR]; 2.876, 95% confidence
interval [95% CI]; 1.614-5.125, p<0.001), nonstenotic plaques confirmed by coronary
angiography (OR; 3.423, 95% CI; 1.764-6.642, p<0.001), and noncalcified plaques (OR;
3.316, 95% CI; 1.435-7.661, p<0.01).
PFV correlated significantly with the presence of nonstenotic and noncalcified coronary
plaques assessed by multislice computed tomography. Pericardial fat is more highly
associated with early development of CAD than simple anthropometric measures of abdominal
obesity.
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