Abstract 4357547: Epicardial fat thickness as a marker of coronary artery disease in diabetics: A single center study.

Background: Epicardial fat thickness (EFT) has emerged as a potential marker for coronary artery disease (CAD) due to its proximity to coronary vessels and its pro-inflammatory properties. However, its role as a predictor of CAD severity in diabetic patients remains underexplored. This study aimed to evaluate the association between EFT and CAD in a large cohort of type 2 diabetic patients. Methods: This retrospective study was conducted at the Abbas Institute of Medical Sciences (AIMS) between January 2020 and March 2025. A total of 2,340 diabetic patients (mean age: 58.3 ± 9.6 years) were included. Clinical data were collected, and EFT was measured using echocardiography. The presence and severity of CAD were determined through coronary angiography. Data were analyzed using logistic regression, and associations were assessed with 95% confidence intervals (CI) and p-values. Results: Elevated EFT (≥5 mm) was present in 1,281 participants (54.7%). CAD was observed in 1,121 patients (47.9%), with those having elevated EFT showing significantly higher rates of CAD (65.7% vs. 26.3%, p < 0.001). Logistic regression revealed that EFT ≥5 mm was associated with 5.38-fold increased odds of CAD (95% CI: 4.59–6.30, p < 0.001). Additionally, EFT correlated with CAD severity, with a higher prevalence of multi-vessel disease observed in patients with elevated EFT. Conclusions: Elevated EFT is strongly associated with the presence and severity of CAD in diabetic patients, suggesting that EFT may serve as an effective non-invasive marker for CAD risk stratification. Incorporating EFT into routine clinical practice may enhance early detection and management of cardiovascular risk in this high-risk population.