Pericardial and visceral, but not total body fat, are related to global coronary and extra-coronary atherosclerotic plaque burden

Background: To explore the relationship between coronary and extra-coronary atherosclerotic plaque burden with total and regional fat depots among patients undergoing ECG-gated aortic computed tomography angiography (CTA). Methods: The subjects of this study comprised a cohort of consecutive patients who underwent ECG-gated thoracoabdominal CTA. We assessed the number of coronary segments with plaques (segment-involvement score, SIS); and the extra-coronary atherosclerotic plaque burden, comprising the aorta and supra-aortic trunks, iliofemoral arteries, and visceral arteries (extra-coronary SS). Total and regional fat volume (FV) were calculated. Results: A total of 2700 vascular segments were evaluated in 90 patients. Obese patients (n=31, 34%) showed similar coronary SIS (p=0.41) and extra-coronary SS (p=0.22) than non-obese patients. General body fat measurements were not related to atherosclerotic plaque burden scores, without associations between coronary or extra-coronary plaque burden and BMI (p=0.68, and p=0.91), abdominal circumference (p=0.13, p=0.89), total body FV (p=0.50, p=0.98), or abdominal FV (p=0.51, p=0.99). Pericardial FV was related to coronary SIS (p < 0.0001) and extra-coronary SS (p=0.008), and visceral FV was related to the coronary SIS (p=0.006) and extra-coronary SS (p=0.056). Abdominal subcutaneous fat was inversely related to coronary SIS (p=0.038) and extra-coronary SS (p=0.010). Pericardial FV was identified as the only independent predictor of extensive coronary [OR 1.020 (95% CI 1.001-1.039), p=0.036] and extra-coronary [OR 1.018 (95% CI 1.001-1.036), p=0.035] plaque burden. Conclusions: In the present study, pericardial and visceral fat were associated with an increased atherosclerotic burden, whereas we identified an inverse relationship between subcutaneous abdominal fat and plaque burden. (c) 2018 Elsevier B.V. All rights reserved.