Peri-coronary epicardial adipose tissue is related to cardiovascular risk factors and coronary artery calcification in post-menopausal women

Aims To determine whether peri-coronary epicardial adipose tissue (EAT) is associated with vascular risk factors and coronary atherosclerosis. Methods and results In this study, 573 healthy post-menopausal women underwent a cardiac CT scan to assess coronary calcification. Peri-coronary EAT thickness was measured in the areas of right coronary artery (RCA), left anterior descending (LAD) artery, and left circumflex (LCX) coronary artery. Average EAT thickness was 16.5 ± 4.3 mm (range 5.9–34.6) in the RCA area, 6.4 ± 2.2 mm (range 2.0–14.0) in the LAD area, and 10.8 ± 3.0 mm (range 2.8–29.1) in the LCX area. Overall average thickness was 11.2 ± 2.2 mm (range 5.4–19.1). EAT was positively related to age ( P = 0.002). In age-adjusted linear regression models, EAT was positively related to weight ( P < 0.001), waist circumference ( P < 0.001), waist-to-hip ratio ( P < 0.001), body mass index ( P < 0.001), glucose ( P < 0.001), triglycerides ( P = 0.001), use of anti-hypertensive drugs ( P = 0.007), and systolic blood pressure ( P = 0.034), and inversely to HDL cholesterol ( P = 0.005). In multivariable models, age, weight, waist circumference, smoking, and glucose were the main determinants of EAT. EAT showed a graded relation with coronary calcification ( P = 0.026). Conclusion EAT is strongly related to vascular risk factors and coronary calcification. Our findings support the hypothesis that EAT affects coronary atherosclerosis and possibly coronary risk.