Background: Coronary artery disease (CAD) is the most prevalent cardiovascular disease. Even though the definitive diagnosis of CAD is by invasive coronary angiography (CAG), various imaging modalities and their advances have led to the evolution of noninvasive parameters such as epicardial adipose tissue (EAT), which could help in prediction of CAD. However, despite having a good association with CAD, the quantification of EAT is unreliable. The adipose tissue of the atrial septum is considered a surrogate of EAT. We aimed to study the association of interatrial septal thickness (IST) measured by echocardiography with the severity of CAD. Methods: A total of 200 patients with a probable diagnosis of CAD undergoing echocardiography and CAG were studied. The IST was measured using two-dimensional transthoracic echocardiography. The presence or absence, the extent, and the severity of CAD were known by CAG. Relevant statistical analysis was done to look for the association of IST with CAD. Results: The mean age of the population was 51.97 ± 10.19 years and the mean IST was 8.02 ± 3.2 mm. Of the baseline characteristics, age, hypertension, and history of CAD were found to be significantly associated with IST. There was significant association of IST with the presence of any extent of CAD. On multivariate regression analysis, IST was found to be an independent predictor of the presence of CAD, having positive association. A positive correlation (r = 0.868) was found between IST and the severity of CAD. The receiver operating characteristic curve analysis showed that IST >5.7mm predicted the presence of any CAD with a sensitivity of 78.6% and a specificity of 100%. Conclusion: IST, a measure of the adipose tissue of atrial septum, was found to be an independent predictor of the presence and severity of CAD.

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Introduction: The most plausible factor for coronary artery ectasia (CAE), a subset of coronary artery disease (CAD), is extensive inflammation. High-sensitivity C-reactive protein (hs-CRP) and serum uric acid (sUA) are well known markers of inflammation. Most of the previous studies (done in the Western population and of Middle East Asia) evaluated their role individually as a marker of inflammation in CAD. We aimed to investigate the possible association of isolated CAE with inflammation as assessed by the hs-CRP and sUA levels and check whether the inflammatory hypothesis holds good in the south Asian population. Materials and Methods: Patients admitted for coronary angiography with age ≥30 years were evaluated. Patients with both CAE and CAD were excluded. A total of 60 patients were studied. Patients with isolated CAE (30) were compared with an equal number of patients with obstructive CAD (30) and their clinical profile was studied. The hs-CRP, sUA, and novel inflammatory markers such as neutrophil–lymphocyte ratio (NLR), mean platelet volume (MPV), and red cell distribution width (RDW) were compared between the groups. Results: Of the 60 patients studied, males were 56% in the isolated CAE group and 50% in the obstructive CAD group. The hs-CRP (2.39 ± 0.41 vs. 1.41 ± 0.29, P < 0.001) and sUA levels (6.46 ± 0.58 vs. 5.36 ± 0.40, P < 0.001) were significantly elevated in the isolated CAE group compared to the obstructive CAD group. Among the novel inflammatory markers, the NLR (3.98 ± 0.42 vs. 2.91 ± 0.30, P < 0.001) and RDW (12.69 ± 0.27 vs. 12.13 ± 0.48, P < 0.001) were significantly higher in the CAE group compared to obstructive CAD group, whereas the MPV did not have a statistically significant difference (9.5 ± 0.98 vs. 9.6 ± 1.08, P = 0.525). Conclusion: The inflammatory etiology of CAE was supported by an elevated hs-CRP, sUA, and other novel inflammatory markers compared to the atherosclerotic obstructive CAD group.