Background: The thickness of epicardial adipose tissue (EAT) has the potential to act as a novel indicator of cardiac and visceral adiposity and its function in myocardial infarction (MI) diagnosis and therapy. Objective: The main aim of the current study was to determine the EAT thickness by echocardiography in chest pain cases, which was suspected to had ischemic heart disease (IHD). We planned to determine EAT association with coronary artery disease (CAD) severity estimated by SYNTAX score and to examine the echocardiographic EAT usage for determining cardiovascular risk in IHD patients. Patients and Methods: A case control study was conducted on 148 cases with chest pain suspected to have IHD and referred to Cardiology Department Cath lab for doing coronary angiography (CA). All patients underwent physical examination, lead surface ECG, echocardiographic evaluation, EAT thickness assessment, laboratory investigations and CA. Participants were divided into 2 groups; Group I included 74 ischemic patients who underwent elective CA for evaluation of CAD and Group II included 74 subjects with chest pain referred for CA which reveals normal epicardial coronaries. Results: There was a positive correlation among SYNTAX score and age of patients in group I, body mass index (BMI) and waist circumference (WC). There was a positive correlation between SYNTAX score and triglycerides, total cholesterol and LDL in group I while HDL shows significant negative correlation with SYNTAX score. There was a positive correlation between SYNTAX score and EAT, IAS and RVFW. EAT was a significant predictor for CAD severity regarding SYNTAX score. Conclusions: The EAT thickness is useful for early detection of individuals with complicated CAD. EAT thickness was significantly correlated with CAD severity. Echocardiography assessment of EAT can be simply predict CAD severity and help in patient's risk stratification.

Background: Obesity is considered a hazard factor for ischemic heart disease (IHD). However, it has been proposed that obese people may have a good prognosis after cardiac events, a phenomenon identified as the "obesity paradox". Objective: The aim of the present study was to examine the effect of body mass index (BMI) on clinical manifestations and outcomes following acute myocardial infarction (AMI). Patients and methods: A retrospective, single center research was conducted at KAMC, Makkah during 2015-2020. AMI cases were allocated into three groups; Group 1 included non-obese (BMI<25) patients, Group 2 included overweight (25≥BMI<30) and Group 3 included obese (BMI≥30). Results: A total of 3018 AMI cases were enrolled in our study, of whom 834 (28%) patients were obese. Obese cases came with AMI at a younger age than overweight and non-obese ones respectively (P<0.001). Overweight and obese groups were more diabetics, hypertensive, and dyslipidemic. Contrast volume used during coronary angiography (CAG) was much elevated in obese patients than other groups (P<0.001). Overweight and obese patient groups were more in need for thrombus aspiration during CAG than non-obese (40, 38 %, and 22% respectively, P<0.001), and tirofiban use post-procedure (46%, 31%, and 24% respectively, P=0.008) in comparison to the non-obese patient group. Obese patients were less common to have multivessel disease compared to overweight and non-obese groups (24%, 43%, and 33%, respectively, P=0.01). Post-MI ejection fraction has a tendency to be much higher in obese and overweight patients in comparison to non-obese group. Conclusion: Obese patients presented with AMI at a younger age and consequently less common to have multivessel disease.