The relation between pericoronary fat thickness and density quantified by coronary computed tomography angiography with coronary artery disease severity

OBJECTIVE: To study the correlation between epicardial fat thickness (EFT), pericoronary fat thickness (PCFT), and pericoronary fat density (PCFD) with the existence and severity of coronary artery disease (CAD). METHODS: This cross-sectional study included 210 patients referred for multislice CT angiography. Group I normal CTCA, Group II patients had non-obstructive atherosclerosis, and Group III patients had obstructive atherosclerosis. All patients underwent a clinical examination, history taking, and multislice CT angiography. RESULTS: The mean EFT was significantly greater in group III (10.43 ± 2.31 mm) compared to groups II (6.30 ± 1.61 mm) and I (5.06 ± 1.14 mm). The mean PCFT was significantly greater in group III (17.96 ± 2.89 mm) compared to group II (11.47 ± 2.51 mm) and group I (9.67 ± 1.99 mm). PCFD was significantly higher adjacent to the lesion (−80.47 ± 29.14) compared to the normal segment (−109.03 ± 35.24), higher in the obstructive group (−59.44 ± 20.10) compared to the non-obstructive group (−101.51 ± 20.23), but lower in calcified lesions (−89.58 ± 28.94) compared to non-calcified (−75.01 ± 29.20), and mixed lesions (−74.83 ± 26.90). EFT and PCFT cut-off values for predicting obstructive CAD were 8.3 and 12.4 mm, respectively, with 87.1% and 92.9% sensitivity and 92.9% and 86.4% specificity, respectively. CONCLUSION: There is a significant association between epicardial fat thickness, pericoronary fat thickness and density with the severity of coronary artery disease.