Pericoronary adipose tissue: potential for pathological diagnosis and therapeutic applications

Cardiovasc Interv Ther. 2025 Jul;40(3):465-473. doi: 10.1007/s12928-025-01126-5. Epub 2025 Apr 5.

Abstract

Excessive accumulation of epicardial adipose tissue (EAT) is known to be a risk factor for coronary artery disease and heart failure. In particular, it is thought that inflammation of pericoronary adipose tissue (PCAT) affects the pathology of various coronary artery diseases (CAD). EAT and PCAT are thought to be new therapeutic targets for preventing cardiovascular disease. Although there are no established drugs that specifically reduce inflammation of EAT or PCAT, the basic approach is to improve lifestyle-related diseases through exercise and diet, and to use metabolic improvement drugs and anti-inflammatory drugs as soft support. Potential candidates include statins, SGLT2 inhibitors, and GLP- 1 receptor agonists. In addition to conventional treatments that target substances within blood vessels, treatments that target EAT and PCAT by directly enveloping the coronary arteries and myocardium from outside the body are expected to further suppress cardiovascular events.

Keywords: Atherosclerosis; Chronic inflammation; Coronary artery diseases (CAD); Epicardial adipose tissue (EAT); Pericoronary adipose tissue (PCAT); Perivascular adipose tissue (PVAT); Vasa vasorum (VV).

Publication types

  • Review

MeSH terms

  • Adipose Tissue* / pathology
  • Coronary Artery Disease* / diagnosis
  • Coronary Artery Disease* / pathology
  • Coronary Artery Disease* / therapy
  • Coronary Vessels* / pathology
  • Epicardial Adipose Tissue
  • Humans
  • Pericardium* / pathology