Published online May 26, 2015. doi: 10.4330/wjc.v7.i5.287
Peer-review started: September 17, 2014
First decision: October 14, 2014
Revised: January 4, 2015
Accepted: March 30, 2015
Article in press: April 2, 2015
Published online: May 26, 2015
Processing time: 249 Days and 14 Hours
AIM: To compare the predictive value of three methods of epicardial fat (EF) assessment for presence of significant coronary artery disease (CAD) [i.e., epicardial fat volume (EFV), EFV indexed with body surface area (EFV/BSA) and EFV indexed with body mass index (EFV/BMI)].
METHODS: The study was performed on 170 patients (85 women and 85 men) with clinical suspicion of CAD. They aged 26-89 years with a median age of 54 years. The patients were classified into three groups: Group 1: 58 patients with normal coronary arteries; group 2: 48 patients with non-significant CAD and group 3: 64 patients with significant CAD. The three methods for assessment of epicardial fat were retrospectively studied to determine the best method to predict the presence of significant CAD.
RESULTS: The three methods for epicardial fat quantification and measurements, i.e., EFV, EFV/BSA and EFV/BMI with post- hoc analysis showed a significant difference between patients with significant coronary artery disease compared to the normal group. Receiver operating characteristic curve analysis showed no significant difference between the three methods of epicardial fat measurements, the area under curve ranging between 0.6 and 0.62. The optimal cut-off was 80.3 cm3 for EFV, 2.4 cm3/m2 for EFV indexed with BMI and 41.7 cm3/(kg/m2) for EFV indexed with BSA. For this cut-off the sensitivity ranged between 0.92 and 0.94, while specificity varied from 0.31 to 0.35.
CONCLUSION: Any one of the three methods for assessment of epicardial fat can be used to predict significant CAD since all have the same equivalent predictive value.
Core tip: There is a great correlation between the volume of epicardial fat and presence of significant coronary artery disease. There are different methods for quantification of epicardial fat volume (EFV). The aim of the study is to compare the predictive value of the three methods used for quantification of epicardial fat (EFV, EFV indexed with body surface area and EFV indexed with body mass index) for presence of significant coronary artery disease. The study concluded the three methods for assessment of epicardial fat have the same equivalent predictive value for significant coronary artery disease and any one of them can be used as a sensitive predictor for significant coronary artery disease.