Abstract 9977: Prognostic Value of Coronary Artery Calcium and Epicardial Adipose Tissue Assessed by Noncontract Computed Tomography

Abstract

Background: Coronary artery calcium (CAC) and epicardial adipose tissue volume (EATV) as assessed by noncontrast computed tomography (NCT) have demonstrated to be associated with adverse cardiac outcomes. However, it is not well known whether the simultaneous evaluation of CAC and EATV has value in prediction of future cardiac events (CEs). Methods: We studied 712 patients (65 ± 11 years, 61% men) referred for NCT, and assessed CAC and EATV. CAC score was measured using Agatston method. Patients were initially assigned to two groups: low (<100 ml) or high (≥100 ml) EATV. Patients were followed up as to the occurrence of CEs (cardiac death, myocardial infarction, unstable angina requiring hospitalization, and late coronary revascularization). Results: During a 3.8 ± 1.4 years follow-up period, 44 CEs were documented. The prevalence of CAC (93% vs. 62%, p < 0.001) and high EATV (77% vs. 54%, p = 0.002) were significantly higher in patients with CEs than in those without. In Cox regression analysis, CAC (hazard ratio [HR] 5.44, 95% confidence interval [CI] 1.85-23.4, p = 0.001) and high EATV (HR 2.34, 95% CI 1.16-5.14, p = 0.017) were independent predictors of CEs after adjustment of age, gender, and traditional cardiovascular risk factors. Kaplan-Meier event-free survival curves amongst 4 groups divided by absence or presence of CAC and low or high EATV for CEs are shown in Figure. The CE rates were highest in the high EATV group with CAC compared to other groups. Furthermore, when analyzed in groups with CAC, high EATV was associated with CEs even after adjustment of CAC scores (HR 2.25, 95% CI 1.07-5.17, p = 0.031). In contrast, there was no significant difference in adjusted HRs between low and high EATV groups without CAC. Conclusions: The high EATV and the presence of CAC were independent predictors of CEs. Notably, the measurement of EATV in patients with CAC was useful to predict CEs in the near to medium term. The simultaneous evaluation of CAC and EATV can improve prediction of future CEs.