Increased Epicardial Adipose Tissue Thickness is Associated With Angiographic Thrombus Burden in the Patients With Non-ST-Segment Elevation Myocardial Infarction

Bakırcı, Eftal Murat; Değirmenci, Hüsnü; Duman, Hakan; İnci, Sinan; Hamur, Hikmet; Büyüklü, Mutlu; Ceyhun, Gökhan; Topal, Ergün

doi:10.1177/1076029614558113

Cited by 12 publications

(10 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Due to these facts, EAT is thought to be related to the presence and the severity of CAD, coronary plaque morphology and plaque rupture, myocardial ischemia, and major adverse cardiac events (MACE) in patient with ACS. In a recent study, increased EAT thickness were independent predictors of coronary thrombus formation in patients with NSTEMI who underwent pPCI and also coronary thrombus formation was independently associated with no-reflow phenomenon 12 . In compatible with those studies, the present study has shown that EAT was an independent predictor of coronary thrombus burden in STEMI who underwent pPCI.…”

Section: Discussionmentioning

confidence: 91%

“…Epicardial adipose tissue is related with various genes associated with extracellular matrix remodeling, inflammation, infection, and thrombosis pathways 11 . Inflammatory cells play a major role both in plaque disruption through the matrix degrading metalloproteinases and in triggering thrombosis following plaque disruption through the tissue factor pathway 12 . During that process, tumor necrosis factor α (TNF-α), monocyte chemoattractant protein 1, interleukin 1β (IL-1β), interleukin 6 (IL-6), nerve growth factor, leptin, resistin, plasminogen activator inhibitor 1, and angiotensinogen especially WBC and many other pro-inflamatuar or anti-enflamatur cytokines have crucial roles within this cascade 13,14 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Relationship between epicardial adipose tissue thickness and coronary thrombus burden in patients with ST-elevation myocardial infarction

Uslu¹,

Küp²,

Doğan³

et al. 2020

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

View full text Add to dashboard Cite

Background. Epicardial fat reflects abdominal visceral adiposity and visceral fat plays an important role in the development of an unfavorable metabolic and atherosclerosis risk profile. Intracoronary thrombus burden is an important factor affecting the success of the procedure particularly in patients undergoing percutaneous coronary intervention (PCI). Therefore, determining the factors predicting thrombus burden has great importance in predicting adverse cardiovascular events as well as determining the most appropriate treatment strategy to prevent failure in PCI. Aim. The aim of the current study was to evaluate the relationship between Epicardial adipose thickness (EAT) and thrombus burden in the patients with ST-elevation myocardial infarction (STEMI) who undergo primary PCI (pPCI). Methods. The study was prospective and included patients (n=156) who were referred to Kosuyolu Research and Education hospital with STEMI between 2016 and 2017. Thrombus burden was scored as follows: 0 (no thrombus), 1 (possible thrombus), 2 (definite thrombus <0.5xreference vessel diameter), 3 (definite thrombus 0.5-2xreference vessel diameter), 4 (definite thrombus >2xreference vessel diameter), and 5 (complete vessel occlusion). According to thrombus grade the patients were grouped as low thrombus burden (grades 0-3) and high thrombus burden (grades 4 and 5). EAT, identified as an echo-free space between the myocardium and visceral pericardium, was measured perpendicularly, on the free wall of the right ventricle at both parasternal long-and short-axis views at end-diastole in three cardiac cycles. Results. Fifty-one subjects were in the low thrombus burden group and 105 in the high thrombus burden group. There were no differences in the two groups for LVEF, smoking status, family history of coronary artery disease (CAD), diabetes mellitus (DM), hypertension (HT), and hypercholesterolemia and for total cholesterol, triglyceride, GFR, LDL-C and HDL-C. In multivariate logistic regression analysis the EAT (odds ratio: 2.53, 95% CI: 1.76-3.67; p < .001) was found as an independent predictor of high thrombus burden. Conclusions. The present study showed that EAT was an independent predictor of coronary thrombus burden in STEMI.

show abstract

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Relationship between epicardial adipose tissue thickness and coronary thrombus burden in patients with ST-elevation myocardial infarction

Uslu¹,

Küp²,

Doğan³

et al. 2020

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

View full text Add to dashboard Cite

show abstract

“…Previous studies have demonstrated that age, diabetes mellitus, red cell distribution, intrinsic platelet reactivity, increased mean platelet volume at admission, increased epicardial adipose tissue thickness, bilirubin Levels, monocyte to HDL cholesterol ratio, SYNTAX score and absence of pre-infarction angina were independent predictors of TB in patients with STEMI. [14][15][16][17][18][19][20][21] In this cohort, we did not observe an association between the above mentioned predictors and intracoronary TB in these young adults with STEMI. Thus, the predictors for TB might thus be quite different in young STEMI patients as compared with general STEMI patient cohorts.…”

Section: Other Potential Independent Predictors Of Higher Tbmentioning

confidence: 85%

“…Previous studies showed that the extent of coronary TB in patients with STEMI was associated with age, diabetes mellitus, red cell distribution, intrinsic platelet reactivity, higher troponin and leukocyte concentrations, increased mean platelet volume, increased epicardial adipose tissue thickness, bilirubin levels, monocyte to high-density lipoprotein (HDL) cholesterol ratio and absence of pre-infarction angina. [14][15][16][17][18][19][20][21] It is to note that the study cohorts of above mentioned observations refereed mostly patient population aged >45-years old. Few studies focused on young STEMI patients (≤45 years), and data on determinants of coronary TB in young STEMI patients remain scarce.…”

mentioning

confidence: 99%

Determinants of angiographic thrombus burden and impact of thrombus aspiration on outcome in young patients with ST‐segment elevation myocardial infarction

Dong

et al. 2018

Cathet Cardio Intervent

View full text Add to dashboard Cite

Objectives We aimed to investigate the determinants of thrombus burden (TB) and the impact of thrombus aspiration (TA) on outcome in young adults with ST segment elevation myocardial infarction (STEMI). Background The determinants of TB in young STEMI patients are not fully understood now. Methods The 182 young (age ≤ 45 years) STEMI patients, who underwent coronary angiography and percutaneous coronary intervention (PCI) in our hospital from January 2013 to September 2016, were included. Angiographic TB and impact of TA on major adverse cardiac events (MACEs) were evaluated. Median clinical follow‐up period was 875 (641–1,052) days. Results All patients were male, mean age was 40 ± 5 years. High thrombus burden (HTB) was evidenced in 100 (54.9%) patients. TA was performed in 62 out 100 (62%) patients with high TB (HTB) during PCI. The prevalence of hypertension was significantly higher in the HTB group than in the low thrombus burden (LTB) group (75 vs. 17%, P < 0.001). The proportion of smoking, alcohol consumption, and family history of premature coronary artery disease were similar between HTB and LTB groups. During follow‐up, 2 patients died and 31 patients underwent repeat PCI. MACE rate was significantly higher in the HTB group than in the LTB group (24.0 vs. 9.8%, P = 0.012) and significantly lower in HTB patients with TA than HTB patients without TA (14.5 vs. 39.5%, P = 0.018). Conclusions Hypertension is an independent determinant of HTB and TA could be considered as an effective therapeutic option in young male STEMI patients with HTB.

show abstract

“…By autocrine and paracrine means, it generates various types of anti-/proin ammatory mediators and free fatty acids [8]. More recently, multiple clinical researches have shown that increased EAT deposition plays a pivotal role in the development and progression of ISR [9][10][11][12][13][14], no-re ow [15][16][17][18], infarct size [19,20] or MACE [4,5,13,14] for patients treated with PCI with inconsistent results.…”

Section: Introductionmentioning

confidence: 99%

The Value of Epicardial Adipose Tissue for the Patients Treated with Percutaneous Coronary Intervention: A Systemic Review and Meta-analysis

Xu¹,

Xu²

2020

Preprint

View full text Add to dashboard Cite

BackgroundAccumulating evidences suggest that the prognostic value of epicardial adipose tissue (EAT) on no-reflow, in-stent restenosis (ISR), infarct size, and main adverse cardiovascular events (MACE) for the patients treated with percutaneous coronary intervention (PCI). The relationship between EAT and outcomes of patients underwent PCI is still partly elusive. MethodsTo elucidate the relationship in detail, we searched PubMed, web of science, and the Cochrane Library for studies evaluating the association of EAT and patients treated with PCI. Thirteen studies enrolling 3683 patients were eventually include in our systemic review and meta-analysis. ResultsThe EAT measured by thickness or volume was significantly higher in the ISR group compared to those in the non-ISR group (The standard mean difference -0.34, 95% CI, -0.49, -0.18, p <0.0001; I2 =36%). The incidence of no-reflow was significantly higher in thicker EAT group compared to thin EAT group (pooled relative ratio 1.52, 95%CI 1.29-1,80, p <0.0001; I2 =0%). Thicker EAT was significantly associated with MACEs (pooled relative ratio 1.50, 95% 1.18-1.90, p =0.008). A lower EAT volume is associated with larger infarct size in ST elevated myocardial infarction patients treated with primary PCI (standard mean difference was -5.45, 95% CI -8.10, -2.80; p <0.0001; I2 =0%). In summary, our systemic review and meta-analysis suggest that high EAT is related with a significant increased risk of non-reflow, MACE and decreased infarct size in patients with coronary artery disease treated with PCI. This paradox phenomenon demonstrates that the quality of EAT may play more important role than the solely thickness or volume of EAT.

show abstract

Increased Epicardial Adipose Tissue Thickness is Associated With Angiographic Thrombus Burden in the Patients With Non-ST-Segment Elevation Myocardial Infarction

Cited by 12 publications

References 38 publications

Relationship between epicardial adipose tissue thickness and coronary thrombus burden in patients with ST-elevation myocardial infarction

Relationship between epicardial adipose tissue thickness and coronary thrombus burden in patients with ST-elevation myocardial infarction

Determinants of angiographic thrombus burden and impact of thrombus aspiration on outcome in young patients with ST‐segment elevation myocardial infarction

The Value of Epicardial Adipose Tissue for the Patients Treated with Percutaneous Coronary Intervention: A Systemic Review and Meta-analysis

Contact Info

Product

Resources

About