Relationship between Epicardial Adipose Tissue and High-Risk Coronary Plaque Features in Patients with Suspected Acute Coronary Syndrome

Abstract

Objective: To evaluate the association between EAT volume and attenuation and high-risk coronary plaque (HRP) in patients with suspected acute coronary syndrome (ACS). Material and Methods: In this prospective study were enrolled, from November 2020 to August 2021, consecutive patients who underwent cardiac computed tomography (CCT) for suspected ACS. All exams were performed using a 2x192-slice dual source CT scanner. EAT volume and attenuation were evaluated in all patients. HRP was defined as plaque with more than 2 high-risk features (low attenuation plaque, positive remolding, napkin-ring sign, spotty calcification) on CCT image. Based on the presence or absence of HRP patients were divided into two groups and EAT volume and attenuation were compared. Results: In this study were enrolled 106 patients: 37 with HRP and 69 without HRP. Patients with HRP have higher EAT volume and attenuation than those without HRP, respectively, 119.0±14.0 cm3 vs 96.3±8.3 cm3 (p<0.0001) and -85.7±15.7 HU vs -95.0±18.4 HU (p=0.0108). After adjustment by coronary calcium score (CCS) and coronary stenosis, EAT volume and attenuation were independent risk predictors of presence of HRP. Conclusions: Higher EAT volume and attenuation are associated with HRP in patient with ACS and are independent of CCS and coronary stenosis.