Abstract
We assessed the relationship between the volume of epicardial adipose tissue and long-term outcomes in patients with coronary heart disease (CHD) undergoing percutaneous coronary intervention (PCI). The patients with CHD were followed for at least 2 years after PCI. The epicardial adipose tissue volume (EATV) was measured using multi-slice computed tomography. Cox regression analysis was used to examine the relationship between EATV and clinical outcome. In this study, 500 patients were enrolled and followed up for a median of 25.2 months. The incidence of adverse cardiovascular events was 12.4%. No significant differences were observed in age, sex, proportion of patients with hypertension or diabetes, smoking, drinking, total cholesterol, triglyceride, high-density lipoprotein, or unstable angina pectoris among different EATV quartiles (P>0.05). The EATV was associated with body mass index (P<0.0001), low-density lipoprotein level (P=0.039), high-sensitivity C-reactive protein level (P<0.001), uric acid level (P=0.004), adiponectin level (P<0.001), and left ventricular ejection fraction (P<0.001). Kaplan–Meier analysis indicated a significant difference in survival rate of patients in EATV quartile 1 versus 4 (P=0.019). After adjusting for confounding factors, EATV quartile 4 (>216.15 cm3) was still associated with adverse cardiovascular outcomes (HR = 1.98, 95% CI: 1.15–4.47, P=0.023) compared with quartile 1 (<101.58 cm3). Our data suggest that EATV is an independent predictor of long-term major adverse cardiovascular events in CHD patients after PCI. Therefore, assessment of EATV using multi-slice computed tomography may contribute to risk stratification in these patients.
Highlights
Coronary artery disease (CAD) involves a reduction in blood flow to heart muscles due to a buildup of plaque in the coronary arteries
The present study analyzed the relationships between epicardial adipose tissue volume (EATV) and risk factors for CAD, as well as the influence of EATV on the rate of major adverse cardiovascular event (MACE) in patients with coronary heart disease (CHD) undergoing Percutaneous coronary intervention (PCI)
Few studies have evaluated whether an increased EATV can exacerbate the incidence of MACEs in patients with CHD after PCI, especially in the long-term
Summary
Coronary artery disease (CAD) involves a reduction in blood flow to heart muscles due to a buildup of plaque in the coronary arteries. It is the most common cardiovascular disease [1]. Percutaneous coronary intervention (PCI) has become an important method for diagnosing and treating coronary heart disease (CHD). Patients still have some postoperative complications, such as stent restenosis and stent intimal hyperplasia [3], which increase the risk of major adverse cardiovascular events (MACEs). The postoperative incidence of intravascular thrombosis has decreased significantly with the adoption of drug-coated stents and antiplatelet drugs, postoperative restenosis can still occur in some patients [4]. It is important to identify predictors of complications after PCI
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