Affiliation:
1. Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Clayton, Victoria, Australia
Abstract
Background
Epicardial adipose tissue (
EAT
) is hypothesized to alter atherosclerotic plaque composition, with potential development of high‐risk plaque (
HRP
).
EAT
can be measured by volumetric assessment (
EAT
‐v) or linear thickness (
EAT
‐t). We performed a systematic review and random‐effects meta‐analysis to assess the association of
EAT
with
HRP
and whether this association is dependent on the measurement method used.
Methods and Results
Electronic databases were systematically searched up to October 2016. Studies reporting
HRP
by computed tomography or intracoronary imaging and studies measuring
EAT
‐v or
EAT
‐t were included. Odds ratios were extracted from multivariable models reporting the association of
EAT
with
HRP
and described as pooled estimates with 95% confidence intervals (
CIs
). Analysis was stratified by
EAT
measurement method. Nine studies (n=3772 patients) were included with 7 measuring
EAT
‐v and 2 measuring
EAT
‐t. Increasing
EAT
was significantly associated with the presence of
HRP (odds ratio:
1.26 [95%
CI,
1.11–1.43];
P
<0.001). Patients with
HRP
had higher
EAT
‐v than those without (weighted mean difference: 28.3 mL [95%
CI,
18.8–37.8 mL];
P
<0.001).
EAT
‐v was associated with
HRP (odds ratio:
1.19 [95%
CI,
1.06–1.33];
P
<0.001); however,
EAT
‐t was not (odds ratio: 3.09 [95%
CI,
0.56–17];
P
=0.2). Estimates remained significant when adjusted for small‐study effect bias
(odds ratio:
1.13 [95%
CI,
1.03–1.28];
P
=0.04).
Conclusions
Increasing
EAT
is associated with the presence of
HRP,
and patients with
HRP
have higher quantified
EAT
‐v. The association of
EAT
‐v with
HRP
is significant compared with
EAT
‐t; however, a larger scale study is still required, and further evaluation is needed to assess whether
EAT
may be a potential therapeutic target for novel pharmaceutical agents.
Clinical Trial Registration
URL
:
https://www.crd.york.ac.uk/
. Unique identifier:
CRD
42017055473.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine
Cited by
104 articles.
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