Epicardial fat thickness can predict severity and multivessel distribution in Egyptian patients with atherosclerotic coronary artery stenosis

Abstract

Background: Epicardial fat, in addition to its secretory function, may have an important role in predicting and stratifying cardiovascular risk. There is a paucity of data regarding correlation between epicardial fat thickness and coronary artery disease in Egypt. Aim of the study: To study the relationship between epicardial fat thickness (EFT) measured by trans-thoracic echocardiography (TTE) and severity of coronary artery disease (CAD) and its distribution in Egyptian population. Methods: Our study was a prospective observational case control study that was conducted upon 150 patients with stable CAD presented to the cardiology departments in Ain Shams University hospitals and Al-Zaitoun Specialized hospital from March to October, 2015. EFT was measured by TTE for all patients at the same day of performing invasive coronary angiography (CA). We studied the statistical correlation between EFT and presence of CAD, also we tried to find if EFT is related to severity of CAD (according to Gensini score) or its distribution. Results: The study population was divided according to CA results to 2 groups; patients’ group having atherosclerotic CAD consisting of 100 patients and control group consisting of 50 patients with normal coronaries. All the well- known risk factors of CAD (male sex, smoking, hypertension, diabetes, dyslipidemia, increased body mass index) were significantly more prevalent in the patients’ group. Patients had significantly lower systolic and diastolic functions. EFT was significantly correlated to presence of CAD (P < 0.001) with a cut-off value of 5.5 mm. EFT was significantly correlated to severity of CAD assessed by Gensini score (P < 0.001). Also we found a significant positive correlation between EFT and number of vessels affected (P < 0.001). Conclusion: EFT is a good predictor of CAD severity and multivessel affection in Egyptian patients. It is also a potentially promising predictor for the presence of CAD.