Relationship between epicardial adipose tissue and coronary atherosclerosis by CCTA in young adults (18–45)

Epicardial adipose tissue (EAT) is implicated in the pathogenesis and progression of coronary artery disease (CAD). Limited data exists on the interplay between EAT and atherosclerosis in young individuals. Our study aims to explore the relationship between EAT and CAD in a young cohort.All young (18–45 years) patients without prior CAD, referred for coronary computed tomography angiography (CCTA) from 2016 to 2022 were included. EAT volume and coronary artery calcium (CAC) were calculated from dedicated non-contrast scans. Coronary plaque presence, extent, and volume were quantified from CCTA. Multivariable logistic regression models for the presence of CAD, defined as any coronary atherosclerosis, were performed.Overall, 712 patients (39±4.8 years, 54 % female) with 45 % Hispanic, and 21 % non-Hispanic Black were included. Patients with CAD had higher EAT volume than those without (80.80 mL ± 36.00 vs 55.16 mL ± 27.92; < 0.001). In those with CAC=0, higher EAT was associated with the presence of CAD compared to lower EAT volume ( < 0.001). An EAT volume >76 mL was associated with higher CAC ( < 0.001), segment involvement score ( < 0.001), and quantitative total, non-calcified, and low-attenuation plaque volumes ( < 0.002). At multivariable analysis, EAT volume (per 10 mL, OR: 1.21; 95 %CI: 1.12–1.30; < 0.0001) was independently associated with the presence of CAD.In a diverse cohort of young adults without history of CAD and undergoing a clinically indicated CCTA, EAT volume was independently associated with the presence of CAD. Our findings highlight EAT potential as a novel marker for CAD risk-assessment and a potential therapeutic target in young patients.

心外膜脂肪组织（EAT）与冠状动脉疾病（CAD）的发病机制和进展有关。关于年轻人中EAT与动脉粥样硬化之间相互作用的数据有限。我们的研究旨在探索年轻人群中EAT与CAD之间的关系。 纳入2016年至2022年期间因冠状动脉计算机断层扫描血管造影（CCTA）而被转诊的所有无CAD病史的年轻（18 - 45岁）患者。通过专门的非对比扫描计算EAT体积和冠状动脉钙（CAC）。从CCTA量化冠状动脉斑块的存在、范围和体积。对定义为任何冠状动脉粥样硬化的CAD存在情况进行多变量逻辑回归模型分析。 总体而言，纳入了712名患者（39±4.8岁，54%为女性），其中45%为西班牙裔，21%为非西班牙裔黑人。患有CAD的患者EAT体积高于未患病者（80.80 mL±36.00对比55.16 mL±27.92；P < 0.001）。在CAC = 0的患者中，与EAT体积较低者相比，EAT较高与CAD的存在相关（P < 0.001）。EAT体积>76 mL与较高的CAC（P < 0.001）、节段受累评分（P < 0.001）以及定量的总斑块体积、非钙化斑块体积和低衰减斑块体积（P < 0.002）相关。在多变量分析中，EAT体积（每10 mL，比值比：1.21；95%置信区间：1.12 - 1.30；P < 0.0001）与CAD的存在独立相关。 在一组无CAD病史且因临床需要进行CCTA的不同年轻成人队列中，EAT体积与CAD的存在独立相关。我们的研究结果强调了EAT作为CAD风险评估的新标志物以及年轻患者潜在治疗靶点的可能性。