Abstract 12088: Low Computed Tomography Attenuation Value of Epicardial Fat is a Useful Marker for Coronary Stenosis

Abstract

Background: Epicardial fat volume (EFV) is recognized as an independent risk factor for coronary atherosclerosis. However, it remains unclear whether the computed tomography (CT) attenuation value of epicardial fat is associated with coronary stenosis. Methods: We analyzed the association of epicardial fat CT attenuation value (EFCTA) and EFV with obstructive coronary artery disease (CAD) in 355 patients (203 men; mean age, 68 ± 11 years) who underwent coronary CT angiography. EFCTA was calculated as the mean CT values of 5 regions of interest in epicardial fat. Results: A total of 200 (56.3%) patients were judged to have obstructive CAD. There was a strong correlation between EFCTA and EFV (R=-0.618, P<0.001). EFCTA and EFV were significantly lower and higher, respectively, in patients with obstructive CAD (EFCTA, -93.0 HU [interquartile range, IR -101.0 - -84.6]; EFV, 110 mL [IR 83 - 146]) than in those without (EFCTA, -88.8 HU [IR -95.6 - -79.4], P<0.001; EFV, 89 mL [IR 68 - 122], P<0.001). In logistic regression analysis using age and gender as covariates, the lowest EFCTA quartile (<-98.8 HU) was significantly associated with obstructive CAD (odds ratio [OR] 3.27, 95% confidence interval [CI] 1.68 - 6.34, P<0.001). Age- and gender-adjusted logistic regression analysis showed that the highest EFV quartile (≥138 mL) had a significant association with obstructive CAD (OR 2.59, 95% CI 1.35 - 4.96, P=0.004). When age, gender, body mass index, smoking, estimated glomerular filtration rate (eGFR), hypertension, dyslipidemia, diabetes, and quartiles of EFCTA and EFV were used as independent valuables, the association of the lowest EFCTA quartile, but not the highest EFV quartile, with obstructive CAD remained statistically significant (OR 2.48, 95% CI 1.05 - 5.85, P=0.038). Conclusions: Low EFCTA was significantly associated with obstructive CAD, independent of traditional cardiovascular risk factors, suggesting that EFCTA may be a novel marker for assessment of CAD.