Heart fat tied to coronary artery spasms

Epicardial adipose tissue (EAT) is a strong indicator of coronary artery spasms, a new study has found. Abdominal (AAT) and abdominal visceral (AVAT) adipose tissue areas, on the other hand, are not.

The study included 110 patients undergoing coronary computed tomography (CT) for the assessment of coronary artery disease. None of the participants showed significant evidence of stenosis, and all were subsequently subjected to a spasm provocation test. Adipose tissue volume and area were evaluated from the CT images.

After the spasm test, 77 patients were deemed to be spasm-positive, and the remaining 33 were assigned to the spasm-negative comparison group. Aside from current smoking, which was significantly more prevalent in spasm-positive participants (p=0.04), both groups were comparable in terms of baseline characteristics.

CT also detected a significant between-group difference in EAT volume, which was higher in spasm-positive patients (108±38 vs 87±34 cm³; p<0.01). No such trend was reported for AAT (p=0.32) or AVAT (p=0.27) areas.

Multivariate logistic regression analysis found that EAT (odds ratio, 1.198, 95 percent confidence interval [CI], 1.035–1.388; p=0.016), but not AAT or AVAT, was a significant predictor of coronary artery spasms.

Receiver operating characteristic curves also found that EAT had a decent capability of discriminating between patients in the spasm-positive and -negative groups (area under the curve, 0.667, 95 percent CI, 0.557–0.778; p<0.01). At a cut-off volume of 96.5 mL, the sensitivity and specificity estimates were 63.6 percent and 66.7 percent, respectively.