Elevated epicardial fat thickness (>5 mm) was associated with a significantly higher prevalence of significant coronary artery disease (68.8% vs. 33.3%, p<0.001) and greater ischemic burden.
Observational (n=125)
Is epicardial fat thickness associated with coronary artery disease severity and stress-induced myocardial ischemia in patients with suspected stable angina?
Epicardial fat thickness measured by echocardiography correlates with angiographic CAD severity and ischemic burden, suggesting utility for non-invasive risk stratification.
Absolute Event Rate: 68.8% vs 33.3%
p-value: p=<0.001
Background/Objectives: Epicardial fat thickness (EFT) is an echocardiographic marker of epicardial adipose tissue that has been linked to coronary atherosclerosis, but its relationship with both coronary artery disease (CAD) severity and myocardial ischemia remains incompletely assessed. This study evaluated the association between EFT, angiographic CAD severity, and stress-induced myocardial ischemia. Methods: In a prospective study, 125 consecutive patients with suspected stable angina underwent transthoracic echocardiography with EFT measurement, dobutamine stress echocardiography, and coronary angiography. EFT was measured at end-systole in the parasternal long-axis view. Significant CAD was defined as ≥50% stenosis in at least one major epicardial coronary artery. Myocardial ischemia was assessed using peak-stress wall motion score index (WMSI). Results: Significant CAD was present in 56% of patients. Mean EFT was significantly higher in patients with significant CAD compared with those without (7.8 ± 2.0 mm vs. 5.5 ± 1.5 mm; p 5 mm had a significantly higher prevalence of significant CAD (68.8% vs. 33.3%; p < 0.001) and were older, with higher body mass index and a greater prevalence of hypertension and obesity. Additionally, peak-stress WMSI was significantly higher in patients with elevated EFT (1.08 ± 0.07 vs. 1.04 ± 0.05; p = 0.005), indicating a greater ischemic burden. Conclusions: EFT is associated with both the anatomical severity of CAD and the extent of stress-induced myocardial ischemia, supporting its potential role in non-invasive risk stratification of patients with suspected CAD.
Charisopoulou et al. (2026) conducted an observational in suspected stable angina (n=125). Elevated epicardial fat thickness (EFT > 5 mm) vs. EFT ≤ 5 mm was evaluated on Significant coronary artery disease (≥50% stenosis in at least one major epicardial coronary artery) (p=<0.001). Elevated epicardial fat thickness (>5 mm) was associated with a significantly higher prevalence of significant coronary artery disease (68.8% vs. 33.3%, p<0.001) and greater ischemic burden.