ECHOCARDIOGRAPHIC EPICARDIAL FAT THICKNESS ON SHORT TERM PROGNOSIS IN PATIENTS WITH ACUTE CORONARY SYNDROME

Background: Previously, the authors revealed that epicardial fat thickness was significantly correlated with the severity of coronary artery disease in patients with known coronary artery disease. We evaluated whether echocardiographic epicardial fat thickness was associated with short term prognosis in patients with acute coronary syndrome. Methods: Two hundred and sixty five consecutive acute coronary syndrome (ACS) patients who underwent successful coronary stenting were studied. Epicardial fat thickness on the free wall of right ventricle was measured at end-diastole from the parasternal long-axis views of three cardiac cycles. 30 days follow-up was obtained in all patients and clinical outcomes were compared with epicardial fat thickness. Results: Mean value of epicardial fat thickness was 5.36 mm (range 0.44 to 16.55 mm). Major adverse cardiac events (MACE) were developed in 19 patients (7.2%) during 30 days; 2 cases of cardiac death, 11 of non fatal Q wave myocardial infarction (QMI), 4 of revascularization and 2 of ischemic stroke. Incidence of occlusion by thrombi (4.5% vs. 21.2%, p=0.016), Gensini's score (44.52${\pm}$31.06 vs. 61.00${\pm}$30.68, p=0.027) and epicardial fat thickness (5.19${\pm}$2.13 vs. 7.51${\pm}$ 3.87 mm, p=0.018) ere significantly higher in patients with MACE than those without MACE. Significant correlations were demonstrated between epicardial fat thickness and age (r=0.193, p=0.002), fibrinogen (r=0.145, p=0.022) and LDL-cholesterol (r=0.136, p=0.027). Multivariate analysis showed that epicardial fat thickness (OR 1.479, 95% CI 1.183- 1.848, p=0.001) was an independent predictor of 30 days MACE. Conclusion: Epicardial fat thickness was significantly correlated with short term prognosis in patients with ACS.