Abstract 13243: Pericardial Fat is a Useful Predictor of Future Cardiovascular Events Independent of High-Risk Coronary Plaques

Abstract

Background: Pericardial fat is recognized as a risk factor for coronary stenosis. However, it remains unclear whether ectopic fat deposition, such as pericardial fat and intrathoracic fat, is an independent predictor of future cardiovascular events. Methods: We measured pericardial fat volume (PFV) and intrathoracic fat volume (IFV) in 355 patients (203 men; mean age, 68.1 ± 10.6 years) who underwent coronary computed tomography angiography. Among 200 patients who were judged to have obstructive coronary artery disease (CAD), cardiovascular events, defined as death, acute coronary syndrome, cerebral stroke, heart failure, and coronary revascularization, were assessed at 5 years. Results: There was a strong association between PFV and IFV (R=0.707, P<0.001). Body mass index (BMI) was significantly associated with PFV (R=0.538, P<0.001) and IFV (R=0.633, P<0.001). PFV and IFV were significantly larger in patients with high-risk coronary plaque (HRP), including low-density plaque, positive remodeling, and spotty calcification, than in those without (PFV, 106 mL [interquartile range, IR 80-144] vs. 85 mL [IR 61-112], P<0.001; IFV, 110 mL [IR 68-158] vs. 90 mL [IR 55-123], P=0.006). Among patients with obstructive CAD, 38 patients developed a cardiovascular event during 5 years. Patients with PFV of median or greater (≥110 mL) had a significantly higher risk of events than those with PFV below median (P=0.025). Patients with IFV of median or greater (≥118 mL) had a higher risk of events than those with IFV below median (P=0.047). When age, gender, BMI, HRP, PFV, and IFV were included in a Cox regression model, PFV, but not IFV, was a significant predictor of cardiovascular events (hazard ratio 3.02 per 100 mL increase, 95% confidence interval 1.26-7.26, P=0.014). Conclusions: PFV was predictive of cardiovascular events independent of other obesity parameters and HRP, indicating that pericardial fat may have local effects on the development of cardiovascular disease.