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Epicardial Adipose Tissue plays an additional role in cardiovascular risk assessment together with Coronary Artery Calcium Score
Session:
SESSÃO DE COMUNICAÇÕES ORAIS 18 - IMAGEM AVANÇADA E BIOMARCADORES NA ESTRATIFICAÇÃO DE RISCO CARDIOVASCULAR: DA RESSONÂNCIA MAGNÉTICA DE PERFUSÃO À REMODELAGEM CARDÍACA
Speaker:
Ana Débora Câmara De Sá
Congress:
CPC 2025
Topic:
B. Imaging
Theme:
03. Imaging
Subtheme:
03.2 Computed Tomography
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Débora Sá; Maria Isabel Mendonça; Francisco Sousa; Gonçalo Abreu; Matilde Ferreira; João Adriano Sousa; Marco Gomes Serrão; Eva Henriques; Sónia Freitas; António Drumond; Ana Célia Sousa; Roberto Palma Dos Reis
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt">Introduction: </span></strong><span style="font-size:12.0pt">Recent research has shown that Epicardial Adipose Tissue (EAT) and the Coronary Artery Calcium Score (CACS), both assessed through a cardiac computed tomography (CT), are strongly associated with patient prognosis and the risk of adverse cardiovascular (CV) outcomes. Nevertheless, it is unclear if EAT remains an event risk tool when considering the CACS.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt">Objective: </span></strong><span style="font-size:12.0pt">Study the role of Epicardial Adipose Tissue in cardiovascular risk when CAC score influence is present.</span></span></span></p> <p style="margin-right:4px; text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt">Methods:</span></strong><span style="font-size:12.0pt"> A prospective </span><span style="font-size:12.0pt">study with 1024 healthy participants (58.3±8.4 years; 75.6% male) followed during an average of 6.1±4.8 years.</span><span style="font-size:12.0pt"> Non-contrast CT images for CACS were obtained at baseline, and the EAT volume was analyzed. Kaplan-Meier estimator was used to assess the additional predictive value of EAT relative to the CACS in four models for the risk of all-cause CV adverse events. A Cox regression analysis</span><span style="font-size:12.0pt"> was performed with the CACS and EAT combination and adjusted for all other covariables.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt">Results:</span></strong> <span style="font-size:12.0pt">After an extended follow-up period, 41 participants (4%) had CV events. </span><span style="font-size:12.0pt">Kaplan-Meier, stratified by EAT and CAC, showed the lowest EAT and CACS had the best probability of survival, and those with higher EAT volume and CACS had the worst survival.</span><span style="font-size:12.0pt"> After Cox regression analysis, increased EAT and CAC was associated with an adjusted hazard ratio of 5.51 (95% CI: 2.33 to 13.00; p<0.0001), predicting CV events. </span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt">Conclusion</span></strong><span style="font-size:12.0pt">: Increased EAT volume is associated with more CV events, probably due to atherosclerosis advance. There is an incremental predictive value when the increased EAT volume is added to the increased CAC score in predicting CV events. Strategies to reduce EAT volume may decrease subclinical atherosclerosis and improve outcomes with adequate measures like physical exercise, proper diet and pharmaceutical intervention.</span></span></span></p>
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