Association of pericardial fat accumulation rather than abdominal obesity with coronary atherosclerotic plaque formation in patients with suspected coronary artery disease

Objectives: The purpose of this study was to examine the association of pericardial fat with the presence of coronary plaques. Background: Waist circumference, reflecting abdominal obesity, is a risk factor of metabolic syndrome and coronary artery disease (CAD). Adipose tissue secretes many factors implicated in atherogenesis, however, the role of pericardial fat (ectopic visceral fat around coronary arteries) in the pathogenesis of CAD is not clear. Methods: We measured total pericardial fat volume (PFV) and determined presence and characteristics of coronary plaques using 64-slice computed tomography in 171 consecutive patients suspected of CAD (101 men; mean age, 66 +/- 11 years, +/-SD). Results: PFV correlated with age (p < 0.05), body mass index (p < 0.05), waist circumference (p < 0.01), and high-density lipoprotein cholesterol (p < 0.01) by multivariate regression analysis. PFV was significantly larger in patients with coronary plaques, even nonstenotic or noncalcified ones, than those without plaques (any plaques, n = 123; 201 +/- 71 cm(3), nonstenotic plaques, n = 51; 192 +/- 63, noncalcified plaques, n = 32; 196 +/- 56 vs. no plaque, n = 48; 144 +/- 45, p < 0.001, respectively). Multivariate backward logistic regression analysis demonstrated that PFV, but not waist circumference, significantly associated with the presence of any coronary plaques (odds ratio [OR]; 2.876, 95% confidence interval [95% CI]; 1.614-5.125, p < 0.001), nonstenotic plaques confirmed by coronary angiography (OR; 3.423, 95% CI; 1.764-6.642, p < 0.001), and noncalcified plaques (OR; 3.316, 95% CI; 1.435-7.661, p < 0.01). Conclusions: PFV correlated significantly with the presence of nonstenotic and noncalcified coronary plaques assessed by multislice computed tomography. Pericardial fat is more highly associated with early development of CAD than simple anthropometric measures of abdominal obesity. (C) 2009 Elsevier Ireland Ltd. All rights reserved.