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Epicardial adipose tissue (EAT) volume is related to subclinical atherosclerosis and major adverse cardiovascular events (MACE) in asymptomatic subjects
Session:
CO 09 - Cardiologia Preventiva
Speaker:
Joao Adriano Sousa
Congress:
CPC 2021
Topic:
J. Preventive Cardiology
Theme:
28. Risk Factors and Prevention
Subtheme:
28.1 Risk Factors and Prevention – Epidemiology
Session Type:
Comunicações Orais
FP Number:
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Authors:
Joao Adriano Sousa; Isabel Mendonça; Marina Santos; Margarida Temtem; Flávio Mendonça; Ana Célia Sousa; Mariana Rodrigues; Sónia Freitas; Eva Henriques; Sofia Borges; Graça Guerra; António Drumond; Roberto Palma Dos Reis
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong>Introduction:</strong> Epicardial adipose tissue (EAT) is an emerging cardiovascular risk marker. It has been suggested to be an inflammatory mediator with a role in subclinical atherosclerosis and coronary artery disease. However, its prognostic relevance in hard clinical outcomes remains thoroughly unexplored in the literature.</span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong>Aim:</strong> Evaluate the prognostic relevance of EAT, regarding the occurrence of major adverse cardiovascular events (MACE) in an asymptomatic population.</span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong>Methods:</strong> 895 asymptomatic volunteers were prospectively enrolled in a single Portuguese center (mean age 51.9 ± 7.7, 78.5% male) and underwent a median follow-up time of 3.7 years (IQR 5.0). EAT volume was measured by Cardiac Computed Tomography (CCT) using a modified simplified method. Participants were distributed into two groups, above and below the EAT-volume median. We compared both groups regarding the occurrence of MACE through univariate analysis, Kaplan-Meier Survival curves and log-rank test. Association to subclinical atherosclerosis was addressed using correlation between EAT volume and calcium score (Agatson).</span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong>Results:</strong> There is a significant correlation between EAT volume and calcium score (r=0.205, p<0.0001) on non-contrast CCT scan, sustaining that it may play an important role in mediating coronary artery disease and subclinical atherosclerosis. Patients with higher EAT volume, were exposed to higher occurrence of MACE on follow-up [70.4% (19 of 27) vs 49.4% (429 of 868), p=0.032] with a clearer separation of the curves after 5.7 years. </span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong>Conclusion:</strong> In an asymptomatic population, EAT volume seems to be related to subclinical atherosclerosis and to the occurrence of adverse cardiovascular events on long-term follow-up. Our study addresses some unanswered questions, such as the prognostic relevance of EAT as an emerging cardiovascular risk marker.</span></span></p>
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