The Study On The Predictive Value Of Epicardial Adipose Tissue Thickness In Severity Of Coronary Atherosclerotic Disease

Background and Objective: The chart of the clinical sign of coronary atherosclerotic disease(CAD) was from asymptomatic CAD to sudden cardiac death(SCD).Till now, a consistent and convenient risk factor which could predict CAD early has still not been found. Recent researches showed that epicardial adipose tissue(EAT) is suggested to correlate with the CAD. But the relationship of EAT thickness and the presence and extent of angiographic CAD is not sure. In this study, we sought to determine whether EAT thickness was associated or not with the presence and extent of angiographic CAD.Methods: Patients who had chest pain and then received coronary angiography and chest CT examination from January 1, 2015 to October 31, 2015 were chosen for the study. The general clinical data such as admission number, sex, age, family history of CAD and the history of smoking, statin use, hypertension, diabetes and dyslipidemia, and the biochemical indexes and so on were collected. The American Heart Association coronary classification method and Gensini scoring system were used to evaluate the severity of coronary lesion in each patient. The association of EAT thickness beteween Gensini score and the number of lesions vessels was assessed using Spearman correlation analysis.Results: In all, 200 patients with the average age of 66.65 years, which included 122 men accounting for 61% and 98 patients accounting for 49% with angiographic CAD were chosen. Right AVG EAT thickness was an independent risk factor for CAD(OR= 1.633,95%CI :1.338-1.993,P=0.000). EAT thickness was associated with the number of lesions vessels and the Gensini score( r=0.660, P=0.000; r=0.666, P=0.000).On receiver operating characteristic(ROC) curve analysis, the best cut-off for RAVG EAT thickness to predict the presence of a significant coronary stenosis was 11.90 mm(AUC=0.842, sensitivity was92.9%, specificity was 63.7%,Cl95%: 0.789-0.896, P<0.001).Conclusion: EAT thickness was an independent risk factor for coronary heart disease; ourstudy demonstrated a strong association between EAT and the presence and extent of angiographic CAD; the best cut-off of 11.90 mm by MSCT for Right AVG EAT thickness to predict the presence of CAD had good sensitivity and specificity.