Correlation of epicardial adipose tissue thickness by echocardiography with waist circumference, lipid profile, and severity of lesion by coronary angiography in patients with acute coronary syndrome

Context: Epicardial adipose tissue (EAT) thickness on echocardiography can be a promising marker for risk stratification in patients with coronary artery disease (CAD). Aim: To correlate EAT with waist circumference (WC), lipid profile, severity of coronary artery disease on angiography in patients with acute coronary syndrome(ACS). Subjects and Methods: Patients with acute coronary syndrome (ACS) with age >18 years were studied. Their demographic, clinical, biochemical, and angiographic profile was assessed. The correlation of EAT with WC, lipid profile, and the severity of lesion by coronary angiography was assessed. Results: A total of 120 consecutive patients with ACS were studied. The male: female ratio was 4:1. The mean age of presentation was 56.43 +/- 11.39 years. Dyslipidemia was seen in 70 (58.33%) patients, whereas hypertension was seen in 58 (48.3%) patients. The syntax score (SS) was low in 34 (28.3%) and high in 50 (41.67%) patients. Mean EAT was high in patients with high SS compared to those with intermediate and low SS (9.66 +/- 0.33 vs. 6.08 +/- 0.10 vs. 5.90 +/- 0.24 mm, P < 0.001). A significant correlation of EAT was seen with WC r = 0.749, total cholesterol r = 0.934, and high-density cholesterol r = 0.674, P < 0.001. The cutoff value of EAT on echocardiography to diagnose significant CAD (SS >23) was 6.23 mm on receiver operating characteristic curve analysis with an area under the curve being 0.953 and sensitivity of 100% and specificity of 70%. Conclusions: EAT thickness, can be a reliable, easy, noninvasive marker in risk stratification of patients at risk of CAD.