Epicardial adipose tissue volume as a predictor for coronary artery disease in diabetic, impaired fasting glucose, and non-diabetic patients presenting with chest pain

Eur Heart J Cardiovasc Imaging. 2012 Jun;13(6):517-23. doi: 10.1093/ehjci/jes024. Epub 2012 Feb 5.


Aims: Epicardial adipose tissue (EAT) volume has been associated with coronary artery disease (CAD). As diabetes mellitus type 2 (DM2) patients have higher EAT volumes, it has been suggested that EAT may play a role in promoting CAD in these patients. The aim of this study was to examine the association between EAT and CAD in DM2, impaired fasting glucose (IFG) and control patients presenting with stable chest pain.

Methods and results: A total of 410 stable chest pain patients underwent multidetector cardiac computed tomography angiography (CCTA) to assess the presence of CAD. The extent of CAD was expressed as the number of affected segments. The EAT volume was measured using three-dimensional volumetric quantification. The EAT was compared using ANOVA, logistic and linear regression models were used to assess its predictive value. Multivariable regression analysis corrected for traditional risk factors was performed. Eighty-three patients had DM2, 118 IFG and there were 209 controls. DM2 as well as IFG patients had higher EAT volumes compared with controls (98 ± 41, 92 ± 39, and 75 ± 34 cm(3), respectively; P < 0.001). EAT predicted the presence (OR: 1.01; P < 0.001) and the extent of CAD (B: 0.01; P < 0.001). The associations were equal in all subgroups. However, in a multivariable regression model corrected for traditional cardiovascular risk factors, EAT was not an independent predictor for the presence or extent of CAD (OR: 1.00; P = 0.88 and B: -0.11; P = 0.68, respectively).

Conclusion: The EAT volume is associated with CAD in DM2, IFG, and control patients. However, EAT is not an independent predictor for CAD in patients presenting with stable chest pain.

MeSH terms

  • Adipose Tissue / pathology*
  • Analysis of Variance
  • Blood Glucose / analysis
  • Case-Control Studies
  • Chest Pain / diagnostic imaging*
  • Chest Pain / etiology*
  • Contrast Media
  • Coronary Angiography / methods*
  • Coronary Artery Disease / pathology*
  • Fasting
  • Female
  • Humans
  • Imaging, Three-Dimensional / methods
  • Iohexol / analogs & derivatives
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prospective Studies
  • Radiographic Image Interpretation, Computer-Assisted / methods
  • Regression Analysis
  • Retrospective Studies
  • Risk Factors
  • Tomography, X-Ray Computed / methods*


  • Blood Glucose
  • Contrast Media
  • iobitridol
  • Iohexol