Association of Epicardial Fat With Cardiovascular Risk Factors and Incident Myocardial Infarction in the General Population
Association of Epicardial Fat With Cardiovascular Risk Factors and Incident Myocardial Infarction in the General Population
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DOI：
10.1016/j.jacc.2012.11.062
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发表时间：
2013-04-02
影响因子：
24
通讯作者：
Moehlenkamp, Stefan
中科院分区：
文献类型：
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作者：
Mahabadi, Amir A.;Berg, Marie H.;Moehlenkamp, Stefan
目的 本研究旨在确定心外膜脂肪体积是否可以预测一般人群中的冠状动脉事件。 背景 心外膜脂肪组织 (EAT) 被认为可以促进冠状动脉树中的斑块形成。 方法 我们对来自基于人群的前瞻性 Heinz Nixdorf Recall 队列研究（不含心血管疾病）的参与者的 EAT 体积进行了量化。在 8.0 +/- 1.5 年的随访期间评估冠状动脉事件。使用回归分析评估 EAT 与心血管危险因素、冠状动脉钙化 (CAC) 和冠状动脉事件的多变量关联。 结果 在 4,093 名参与者（年龄 59.4 岁，47% 男性）中，130 名受试者发生致命或非致命冠状动脉事件。冠状动脉事件的发生率随 EAT 四分位数的增加而增加（第一和第四四分位数分别为 0.9% 和 4.7%，p < 0.001）。当调整心血管危险因素时，EAT加倍与冠脉事件风险增加1.5倍相关（风险比[HR][95%置信区间（CI）]：1.54[1.09至2.19]），在进一步调整CAC评分后保持不变（HR[95%CI]：1.50[1.07至2.11]）。为了区分有事件的受试者和没有事件的受试者，我们观察到 Harrell's C 的改善趋势，并解释了 EAT 相对于传统心血管危险因素的差异，然而，这并未达到统计显着性（单独危险因素和添加 EAT 的分别为 0.720 至 0.730，p = 0.10，R-2 = 2.73% 至 R-2 = 2.92%，时间依赖性综合辨别改善 = 0.196%）。结论心外膜脂肪与一般人群中的致命性和非致命性冠状动脉事件相关，与传统心血管危险因素无关，并补充了高于 CAC 评分的心脏计算机断层扫描信息。 (J Am Coll Cardiol 2013;61:1388-95) (C) 2013 年，美国心脏病学会基金会
Objectives This study sought to determine whether epicardial fat volume predicts coronary events in the general population.Background Epicardial adipose tissue (EAT) is suggested to promote plaque development in the coronary artery tree.Methods We quantified EAT volume in participants from the prospective population-based Heinz Nixdorf Recall cohort study free of cardiovascular disease. Incident coronary events were assessed during a follow-up period of 8.0 +/- 1.5 years. Multivariable association of EAT with cardiovascular risk factors, coronary artery calcification (CAC), and coronary events was assessed using regression analysis.Results From the overall 4,093 participants (age 59.4 years, 47% male), 130 subjects developed a fatal or nonfatal coronary event. Incidence of coronary events increased by quartile of EAT (0.9% vs. 4.7% for 1st and 4th quartile, respectively, p < 0.001). Doubling of EAT was associated with a 1.5-fold risk of coronary events when adjusting for cardiovascular risk factors (hazard ratio [HR] [95% confidence interval (CI)]: 1.54 [1.09 to 2.19]), which remained unaltered after further adjustment for CAC score (HR [95% CI]: 1.50 [1.07 to 2.11]). For discrimination of subjects with events from those without, we observed a trend for improvement of Harrell's C and explained variance by EAT over traditional cardiovascular risk factors, which, however, did not reach statistical significance (0.720 to 0.730 for risk factors alone and with EAT added, respectively, p = 0.10, R-2 = 2.73% to R-2 = 2.92%, time-dependent integrated discrimination improvement = 0.196%).Conclusions Epicardial fat is associated with fatal and nonfatal coronary events in the general population independent of traditional cardiovascular risk factors and complements information from cardiac computed tomography above the CAC score. (J Am Coll Cardiol 2013;61:1388-95) (C) 2013 by the American College of Cardiology Foundation