Background: Few studies have addressed the relationship between echocardiographic epicardial fat thickness (EFT) and coronary artery calcification in an apparently healthy Asian population, and those that have, are inconsistent.
Methods and results: A total of 2,299 individuals (1,871 men; mean age, 45±8.9 years) were enrolled in the CArdiometabolic risk, Epicardial fat, and Subclinical Atherosclerosis Registry (CAESAR) study and underwent CT for measurement of coronary artery calcium score (CACS) and echocardiography for EFT. According to EFT quartiles, the prevalence of CAC >0 was 8.3%, 16.8%, 24.6%, and 28.3% in the lowest, second, third, and highest EFT quartiles, respectively (P<0.001). On multivariate logistic regression after adjusting for variables with a univariate relationship (P<0.05), the second, third, and highest quartile groups of EFT had higher odds ratios (OR) for the presence of CAC compared with those of the lowest quartile (OR, 1.634; 95% confidence interval (CI): 0.940-2.839; 1.762, 1.019-3.048; and 1.924, 1.107-3.342, respectively), and the increase in absolute EFT was also independently associated with higher OR for the presence of CAC (1.842; 95% CI: 1.057-3.208, P=0.031). Moreover, increasing absolute EFT was associated with increasing CACS on multivariate linear regression (standardized β=0.081, P=0.005).
Conclusions: There was an independent relationship between EFT and coronary artery calcification in Korean adults, suggesting that echocardiographic EFT might be an easily accessible tool for early detection of subclinical coronary atherosclerosis.