Epicardial Adipose Tissue in Patients with Coronary Artery Disease: A Meta-Analysis

Abstract

Objective: The aim of this study is to assess the association between epicardial adipose tissue (EAT) and coronary artery disease (CAD) via meta−analysis. Methods: Specific searches of online databases from January 2000 to May 2022 were conducted. All observational studies evaluating the association between EAT and CAD in PubMed, Web of Science, and the Cochrane Library databases were screened. A meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta−Analyses guidelines (PRISMA). In total, 21 studies encompassing 4975 subjects met the inclusion criteria, including 2377 diagnosed and assigned as the CAD group, while the other 2598 were assigned as the non−CAD group. Subjects in the CAD group were further divided into the severe stenosis group (stenosis ≥ 50%, n = 846) and the mild/moderate stenosis group (stenosis < 50%, n = 577). Results: Both the volume and thickness of EAT in the CAD group were larger compared to the non−CAD group (p < 0.00001). In a subgroup analysis within the CAD group, the severe stenosis group had a larger volume and thickness with respect to EAT when compared to the mild/moderate group (p < 0.001). Conclusions: The enlargement of EAT presented in CAD patients with an association with CAD severity. Although limited by different CAD types and measuring methods for EAT, as well as a smaller sample size, our results suggest that EAT is a novel predictor and a potential therapeutic target for CAD.

Evaluation of epicardial adipose tissue by coronary multi-detector computed tomography: an independent predictor of obstructive coronary artery disease

“…There is growing evidence that epicardial adipose tissue including pericoronary adipose tissue, is related to coronary artery atherosclerosis [10], however, the exact mechanisms are not fully understood. It has been proposed that epicardial adipose tissue can possibly affect CAD via producing cytokines and bioactive molecules with ensuing local inflammation and eventually atherogenesis [11].…”

Recent assessment methods of epicardial adipose tissue

“…Таким образом, увеличение толщины ЭЖТ у пациентов с ИБС было связано с тяжестью заболевания. Полученные результаты позволяют предположить, что ЭЖТ является новым предиктором и потенциальной терапевтической мишенью для ИБС [29].…”

Epicardial Adipose Tissue Hyperinflammation Might be the Broken Thread in Coronary Artery Ectasia Pathogenesis

“…1 A recently published meta-analysis (21 studies encompassing 4975 patients) underscored that greater EAT volume and thickness was associated with increasing CAD severity, regardless of imaging modality used (CCT or TTE). 4 Furthermore, impaired adipokine secretion, such as increased resistin 5 and decreased adiponectin release, 6,7 has also been suggested in CAE cases compared with healthy controls, while the role of EAT-mediated inflammation is highly suspected in the etiopathogenesis of the disease. Importantly, perivascular adipose tissue and fat inflammation may confer an increased risk for cardiovascular events, 8,9 and the suggested pathophysiologic links involve a vicious cycle of inflammation, endothelial dysfunction, and hypercoagulation.…”

“…1 A recently published meta-analysis (21 studies encompassing 4975 patients) underscored that greater EAT volume and thickness was associated with increasing CAD severity, regardless of imaging modality used (CCT or TTE). 4…”