Association between the epicardial adipose tissue thickness and the presence of multivessel disease in patients with acute myocardial infarction

Aim: Epicardial adipose tissue (EAT) is implicated in the development of coronary atherosclerosis. We sought to investigate the association between the EAT thickness and presence of multivessel disease (MV) in patients with acute myocardial infarction (AMI). Methods: We enrolled 45 consecutive patients with AMI who underwent primary percutaneous coronary intervention (PCI). The EAT thickness was measured on echocardiography. A follow-up study was performed using coronary angiography with coronary angioscopy two weeks after primary PCI. Results: Based on the angiographic findings, 21 patients had single-vessel disease (SV) and 24 patients had MV. The EAT thickness in the patients with SV was significantly smaller than that in the patients with MV (1.9±0.9 mm vs 2.8±1.3 mm, p= 0.005, respectively). A multivariate logistic analysis demonstrated that the EAT thickness was the only independent predictor of MV (odds ratio =1.987, 95% confidence interval: 1.089-3.626, p=0.025). An EAT thickness of 2.3 mm was determined to be the optimal cut-off value for predicting MV, with a sensitivity of 70.8% and specificity of 71.4%. Between the thin EAT (<2.3 mm) and the thick EAT (≥2.3 mm) groups, there were no difference in the number of intense yellow plaques in the non-infarct-related artery evaluated on angioscopy (2.0±2.2 vs 1.8±2.0, p= 0.365, respectively). Conclusions: The EAT thickness is closely associated with the presence of MV, but not vessel vulnerability in the non-infarct-related artery, in patients with AMI. Measuring the EAT provides important information for treating patients with AMI.