Introduction: We evaluate the predictive value of epicardial fat thickness (EFT) by echocardiography in the prediction of significant coronary arterial disease (CAD).
Methods: EFT was measured in 704 patients (295 females, mean age: 64.6짹9.4 years) before taking coronary angiography. EFT was calculated as an echo-lucent area on the free wall of the right ventricle at end-diastole in the parasternal long-axis and parasternal short-axis views. The significant CAD was defined as more than 50% of diameter stenosis on quantitative angiography.
Results: Total 524 patients (74.4%) showed significant CAD. In these patients, male, hypercholesterolemic, diabetic and older patients were more frequent. EFT was significantly correlated with age (r=0.245, P<0.001), high sensitivity C-reactive protein (hs-CRP) (r=0.102, P=0.001), creatinine concentration (r=0.106, P=0.005) and total cholesterol level (r=0.095, P=0.012). EFT was thicker (4.9짹1.3 vs. 3.4짹1.1 mm, P<0.001) and hs-CRP was higher (6.0짹10.8 vs. 3.7짹5.9mg/L, P=0.001) in patients with significant CAD. In the prediction of significant CAD by the receiver operating curve according to EFT, the best sensitivity and specificity were obtained when 4.0mm was applied as the criterion. Using this criterion (EFT more than 4.0mm), the sensitivity, specificity and accuracy were 78.3%, 78.5% and 77.6%, respectively. On multivariate analysis, EFT more than 4.0mm was one of the independent factor of predicting significant CAD (Odds ratio, 11.7, 95% confidence interval 7.18~19.06).
Conclusion: These results suggest EFT can be used in predicting significant CAD.