Table 1.
Studies on epicardial and perivascular fat versus CAD prediction or staging
| Ref. | Sampling technique(s) | Number of patients (specific features) | Evaluation of CAD | Relationship vs. epi- or pericardial or perivascular fat | Adjusted for risk factors and/or adiposity |
|---|---|---|---|---|---|
| (2) | Computerized tomography + invasive angiography | 251 | presence of CAD | YES | yes/yes |
| severity | YES | ||||
| (40) | Echocardiography + invasive angiography | 139 | presence of CAD | NO | n.a. |
| degree + no. stenoses | NO | ||||
| (42) | Echocardiography + invasive angiography | 203 | presence of CAD | YES | yes/yes |
| severity (Gensini score) | YES | ||||
| (30) | Echocardiography | 527 | presence of CAD | YES | yes/yes |
| degree of stenosis | YES | ||||
| unstable angina | YES | ||||
| (45) | Computerized tomography | 190 | presence of CAD | YES | yes/yes |
| degree + no. stenoses | NO | ||||
| coronary calcium score | NO | ||||
| calcium × cut-off | YES | ||||
| (52) | Computerized tomography | 573 (healthy women) | coronary calcium score | YES | n.d./no |
| (49) | Computerized tomography | 159 (mixed ethnicity) | calcified plaques (+/−) | YES | yes/yes |
| coronary calcium score | YES | ||||
| (50) | Computerized tomography | 150 | prevalence of CAD | YES | n.d. |
| calcium × cut-off | YES | ||||
| (47) | Computerized tomography | 128 *whole BMI range ^BMI <27 kg/m2 | no. stenoses | NO*/YES^ | n.d. in the low BMI category |
| coronary calcium score | NO*/YES^ | ||||
| (39) | Computerized tomography | 2,726 (with arterial disease) | infrarenal aortic diameter | YES | yes/n.a. |
| (32) | Computerized tomography | 1,155 (clinical CVD excluded) | coronary calcium score | YES | yes/yes |
| aortic calcium score | YES | ||||
| (43) | Computerized tomography | 264/286 (22 excluded) | presence of CAD | YES | yes/n.d. |
| no. plaques + no. segments | YES | ||||
| atherosclerosis score | YES | n.d./yes | |||
| plaque composition | NO | ||||
| (44) | Computerized tomography | 1,267 (9.7% with CVD) | presence of CVD | YES | no/yes |
| prevalent CHD | YES | n.d./yes | |||
| prevalent infarction | YES | n.d./yes | |||
| prevalent stroke | NO | n.d./no | |||
| (48) | Computerized tomography | 1,119 (147 events) (mixed ethnicity) | incident CVD vs. EAT measured at postvisit | YES | yes/yes |
| (41) | Echocardiography + invasive angiography | 150 | presence of CAD | YES | yes/n.d. |
| no. single vs. multivessel | YES | ||||
| Gensini score | YES | ||||
| (22) | Echocardiography + carotid ultrasound | 459 (hypertensive patients) | carotid wall IMT | YES | |
| carotid stiffness | YES | yes/no | |||
| (28) | Computerized tomography + invasive angiography | 71 | stenosis score | YES | |
| atheromatosis score | YES | ||||
| history of ACS | YES | ||||
| total coronary occlusion | YES | yes/yes | |||
| (55) | Echocardiography + invasive angiography | 68 (only women, chest pain, CVD excluded) | coronary flow reserve | YES | yes/n.d. |
| (51) | Computerized tomography | 1,067 (clinical CVD excluded) | coronary calcium score | YES | yes/yes |
| thoracic aorta calcium | YES | no/yes | |||
| abdominal aorta calcium | YES | yes/yes | |||
| (54) | Computerized + positron emission tomography | 161 successful of 292 (cancer patients) | FDG uptake in LAD vs. EAT | YES | yes/yes |
| vs. calcium score | YES | ||||
| (37) | Computerized tomography + carotid ultrasound | 5,770 (mixed ethnicity) | carotid stiffness | YES | yes/yes |
| IMT | YES | ||||
| coronary calcium score | YES | ||||
| (38) | Computerized tomography + carotid ultrasound | 996 | IMT common carotid artery | YES | no |
| internal carotid artery | YES | yes in men | |||
| (53) | Computerized tomography | 311 (coronary segments for plaques and fat volume) | presence of CAD | YES | yes/yes |
| plaque burden | YES | ||||
| (46) | Computerized tomography | 171 (suspected CAD) | presence of CAD | YES | yes/yes |
| stenotic plaque (+/−) | NO | ||||
| calcif. vs. mix vs. noncalcif. plaque | NO | ||||
| (23) | Computerized tomography | 214 (mixed ethnicity) | a) calcif. vs. no plaque | NO | |
| b) mixed vs. noncalcif. | NO | ||||
| a) vs. b) | YES | yes/yes | |||
| calcium score | YES | yes/yes | |||
| severity of stenoses | YES | yes/yes |
Studies include patients referred to imaging for known or suspected CAD, with few exceptions given in parentheses. The last column shows whether the relationships are maintained after adjustment for cardiovascular risk factors or (/) alternative indices of adiposity, namely BMI (in a majority of studies) or waist or amount of visceral fat. ACS, acute coronary syndrome; CHD, coronary heart disease; CVD, cardiovascular disease; calcif., calcification; EAT, epicardial adipose tissue; FDG, 18F-fluorodeoxyglucose; IMT, intima-media thickness; LAD, left anterior descending coronary artery; n.a., not applicable; n.d., indicates that the confounding variables have not been measured, or that they have been measured but not included in a multivariate regression model investigating the target relationship; noncalcif., noncalcified.