The role of epicardial adipose tissue volume and pericoronary fat thickness in the evaluation of coronary artery disease

Aims: To investigate the relationships between epicardial fat volume (EFV), epicardial fat tissue density (EFD), and pericoronary fat tissue thickness (PCFT) and the coronary calcium score (CS). Epicardial fat tissue, which surrounds the coronary arteries, is thought to be associated with cardiovascular diseases. Methods: The study was conducted retrospectively on 255 patients who underwent cardiac CT angiography between January 2025 and October 2025. EFV, EFD, and PCFT measurements were performed on the study participants.Results: The analysis revealed that EFV and PCFT were significantly higher in the atherosclerotic group, whereas EFD was lower in this group. Additionally, a significant positive correlation was observed between EFV and coronary calcium, whereas no significant correlation was observed with EFD. In the binary logistic regression analysis, age, diabetes, hypertension, EFV, and RCA-PCFT were associated with the presence of coronary calcium. Furthermore, in ordinal regression, only hypertension and age were associated with the calcium score.Conclusion: The findings of this study suggest that epicardial fat may serve as a biomarker for coronary artery disease.