th specific strategies directed towards the same.

5. Limitations

Ÿ The present study being a cross sectional study could not establish causality between EFT and CAD. A prospective study needs to be undertaken for the same in future.

Ÿ The controls being healthy individuals were devoid of risk factors. Studies in non CAD patients with presence of risk factors would be more appropriate.

Ÿ Sample size of our study was 100 patients. Study involving large sample size would yield better results.

Ÿ As it is a hospital based study, it might not give the exact representation of the entire population.

6. Conclusion

Epicardial fat thickness significantly correlated with the severity of coronary artery stenosis angiographically and can be used for risk stratification. Echocardiography is an easy, inexpensive and non-invasive method for measurement of epicardial fat. There are several established CAD risk factors, such as obesity, hypertension, diabetes mellitus, smoking and dyslipidemia, but among these well known risk factors, epicardial fat thickness emerged as an independent predictor of CAD. In order to include it in the armamentarium of conventional tools for assessment of coronary artery disease, a larger study with promising results needs to be done. However, in the present scenario, we can safely conclude that this novel parameter holds great importance for assessment of CAD in future.

Conflicts of Interest

The authors declare no conflicts of interest regarding the publication of this paper.

Cite this paper

Swaroop, S., Tripathy, S.K., Sahu, N.C., Das, B. and Satpathy, M. (2019) Epicardial Fat Thickness and its Association as a Risk Factor for Coronary Artery Disease. World Journal of Cardiovascular Diseases, 9, 193-201. https://doi.org/10.4236/wjcd.2019.93017

References

  1. 1. Montalescot, G., et al. (2013) Task Force on the Management of Stable CAD of ESC. European Heart Journal, 34, 2949-3003.

  2. 2. Gupta, R., Mohan, I. and Narula, J. (2016) Trends in Coronary Heart Disease Epidemiology in India. Annals of Global Health, 82, 3007-3015. https://doi.org/10.1016/j.aogh.2016.04.002

  3. 3. Iacobellis, G. and Willens, H.J. (2009) Echocardiographic Epicardial Fat: A Review of Research and Clinical Applications. Journal of the American Society of Echocardiography, 22, 1311-1319. https://doi.org/10.1016/j.echo.2009.10.013

  4. 4. Shioji, K., Moriguchi, A., Moriwaki, S., et al. (2005) Hypoadiponectinemia Implies the Development of Atherosclerosis in Carotid and Coronary Arteries. Journal of Cardiology, 46, 105-112.

  5. 5. Sharma, A.M. (2002) Adipose Tissue: A Mediator of Cardiovascular Risk. International Journal of Obesity and Related Metabolic Disorders, 26, S5-S7. https://doi.org/10.1038/sj.ijo.0802210

  6. 6. Libby, P., Ridker, P.M. and Maseri, A. (2002) Inflammation and Atherosclerosis. Circulation, 105, 1135-1143. https://doi.org/10.1161/hc0902.104353

  7. 7. Cheng, K.H., Chu, C.S., Lee, K.T., et al. (2008) Adipocytokines and Proinflamatory Mediators from Abdominal and Epicardial Adipose Tissue in Patients with Coronary Artery Disease. International Journal of Obesity, 32, 268-274. https://doi.org/10.1038/sj.ijo.0803726

  8. 8. Otsuka, F., Sugiyama, S., Kojima, S., et al. (2006) Plasma Adiponectin Levels Are Associated with Coronary Lesion Complexity in Men with Coronary Artery Disease. Journal of the American College of Cardiology, 48, 1155-1162. https://doi.org/10.1016/j.jacc.2006.05.054

  9. 9. Iacobellis, G., Pistilli, D., Gucciardo, M., et al. (2005) Adiponectin Expression in Human Epicardial Adipose Tissue in Vivo Is Lower in Patients with Coronary Artery Disease. Cytokine, 29, 251-255.

  10. 10. Akyurek, O., Efe, D. and Kaya, Z. (2015) Epicardial Fat Thickness and its Association with Cardiovascular Risk in Patients with Type 2 Diabetes Mellitus. European Journal of General Medicine, 12, 131-135.

  11. 11. Ahn, S.G., Lim, H.S., Joe, D.Y., Kang, S.J., Choi, B.J. and Choi, S.Y. (2008) Relationship of Epicardial Adipose Tissue by Echocardiography to Coronary Artery Disease. Heart, 94, e7. https://doi.org/10.1136/hrt.2007.118471

  12. 12. Bachar, G., Khasminsky, V., Dicker, D., Kornowski, R. and Atar, E. (2014) Increased Epicardial Adipose Tissue Thickness in Hypertensive Patients: MDCT Study. European Society of Radiology, 1, 1-25.

  13. 13. El-Aziz, A., Walaa, F., Ahmed, M.K. and Badr, W.A. (2017) Association of Echocardiographic Epicardial Fat with the Extent of Coronary Artery Disease. Menoufia Medical Journal, 30, 842-849.

  14. 14. Cavalcante, J.L., et al. (2012) Association of Epicardial Fat, Hypertension, Subclinical Coronary Artery Disease and Metabolic Syndrome with Left Ventricular Diastolic Dysfunction. American Journal of Cardiology, 110, 1793-1798. https://doi.org/10.1016/j.amjcard.2012.07.045

  15. 15. Whelton, P.K., Carey, R.M., Aronow, W.S., et al. (2018) Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology, 71, e127-e248. https://doi.org/10.1016/j.jacc.2017.11.006

  16. 16. (1997) Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care, 20, 1183-1197. https://doi.org/10.2337/diacare.20.7.1183

  17. 17. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel, III) (2002) Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III): Final Report. Circulation, 106, 3143-3421. https://doi.org/10.1161/circ.106.25.3143

  18. 18. Iacobellis, G., Assael, F., Ribaudo, M.C., et al. (2003) Epicardial Fat from Echocardiography: A New Method for Visceral Adipose Tissue Prediction. Obesity Research, 11, 304-310. https://doi.org/10.1038/oby.2003.45

  19. 19. Iacobellis, G., Ribaudo, M.C., Assael, F., et al. (2003) Echocardiographic Epicardial Adipose Tissue Is Related to Anthropometric and Clinical Parameters of Metabolic Syndrome: A New Indicator of Cardiovascular Risk. The Journal of Clinical Endocrinology & Metabolism, 88, 5163e8.

  20. 20. Sullivan, D.R., Marwick, T.H. and Freedman, S.B. (1990) A New Method of Scoring Coronary Angiograms to Reflect Extent of Coronary Atherosclerosis and Improve Correlation with Major Risk Factors. American Heart Journal, 119, 1262-1267. https://doi.org/10.1016/S0002-8703(05)80173-5

  21. 21. Bettencourt, N., Toschke, A.M., Leite, D., et al. (2012) Epicardial Adipose Tissue Is an Independent Predictor of Coronary Atherosclerotic Burden. International Journal of Cardiology, 28, 26-32. https://doi.org/10.1016/j.ijcard.2010.12.085

  22. 22. Meenakshi, K., Rajendran, M., Srikumar, S. and Chidambaram, S. (2016) Epicardial Fat Thickness: A Surrogate Marker of Coronary Artery Disease—Assessment by Echocardiography. Indian Heart Journal, 68, 336-341. https://doi.org/10.1016/j.ihj.2015.08.005

  23. 23. Jeong, J.W., Jeong, M.H., Yun, K.H., Oh, S.K., Park, E.M. and Kim, Y.K. (2007) Echocardiographic Epicardial Fat Thickness and Coronary Artery Disease. Circulation Journal, 71, 536-539. https://doi.org/10.1253/circj.71.536

  24. 24. Sinha, et al. (2016) Epicardial Adipose Tissue Thickness and Its Association with the Presence and Severity of Coronary Artery Disease in Clinical Setting: A Cross-Sectional Observational Study. Journal of Clinical Medicine Research, 8, 410-419. https://doi.org/10.14740/jocmr2468w

  25. 25. Park, et al. (2016) Echocardiographic Epicardial Fat Thickness Is a Predictor for Target Vessel Revascularization in Patients with ST Elevation Myocardial Infarction. Lipids in Health and Disease, 15, 194. https://doi.org/10.1186/s12944-016-0371-8

  26. 26. Tanami, et al. (2015) Lack of Association between Epicardial Fat Volume and Extent of Coronary Artery Calcification, Severity of Coronary Artery Disease, or Presence of Myocardial Perfusion Abnormalities in a Diverse, Symptomatic Patient Population. Circulation: Cardiovascular Imaging, 8, e002676. https://doi.org/10.1161/CIRCIMAGING.114.002676

  27. 27. Aydin, A.M., Kayali, A., Poyraz, A.K. and Aydin, K. (2015) The Relationship between Coronary Artery Disease and Pericoronary Epicardial Adipose Tissue Thickness. Journal of International Medical Research, 43, 17-25. https://doi.org/10.1177/0300060514558323

  28. 28. Picard, F.A., et al. (2014) Epicardial Adipose Tissue Thickness Correlates with the Presence and Severity of Angiographic Coronary Artery Disease in Stable Patients with Chest Pain. PLoS ONE, 9, e110005. https://doi.org/10.1371/journal.pone.0110005

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