Higher epicardial adipose tissue volume is associated with higher coronary fatty plaque volume and is regulated by waist circumference but not EPA+DHA supplementation

J Clin Lipidol. 2024 Sep-Oct;18(5):e773-e786. doi: 10.1016/j.jacl.2024.06.006. Epub 2024 Jul 5.

Abstract

Background: Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) supplementation lower triglyceride levels. The impact on epicardial adipose tissue volume (EATV), which is associated with cardiovascular events, is unclear.

Objective: To determine if triglyceride reduction with EPA+DHA supplementation decreases EATV and whether EATV affects coronary plaque.

Methods: 139 subjects with coronary artery disease (CAD) on statins were randomized to 3.36 g EPA+DHA daily or none (control) for 30 months. EATV, coronary plaque volumes and coronary artery calcium score were measured with coronary computed tomographic angiography.

Results: Change in triglyceride level correlated with change in EATV (r=0.236; p=0.006). Despite a 6.7% triglyceride reduction (p=0.021) with EPA+DHA supplementation compared to no change in control (between group p=0.034); both groups had similar reductions in EATV possibly due to statin treatment. EATV above the median (>115.6 cm3) was the only determinant of baseline coronary fatty plaque volume (β=2.4, p=0.010). After multivariate adjustment, waist circumference, a surrogate of abdominal visceral adiposity, was the only determinant of baseline EATV (odds ratio {OR]:1.093; 95% confidence interval [CI]:1.003-1.192, p=0.042). Moreover, increase in waist circumference was the only predictor of an increase in EATV at 30 months (β=0.320, p=0.018).

Conclusions: EATV is associated with higher coronary fatty plaque volume and is regulated by waist circumference but not EPA+DHA supplementation at 30-month follow-up in CAD patients on statin treatment. The direct correlation between waist circumference and EATV suggests that maintaining a healthy weight may limit EATV and coronary fatty plaque volume, potentially leading to a decrease in cardiovascular events.

Keywords: Coronary artery calcium score; Coronary computed tomographic angiography; Coronary fatty plaque; Epicardial adipose tissue; Omega-3 fatty acids.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adipose Tissue* / diagnostic imaging
  • Adipose Tissue* / drug effects
  • Adipose Tissue* / metabolism
  • Adipose Tissue* / pathology
  • Aged
  • Coronary Artery Disease* / diagnostic imaging
  • Coronary Artery Disease* / drug therapy
  • Coronary Artery Disease* / pathology
  • Dietary Supplements*
  • Docosahexaenoic Acids* / administration & dosage
  • Docosahexaenoic Acids* / pharmacology
  • Docosahexaenoic Acids* / therapeutic use
  • Eicosapentaenoic Acid* / administration & dosage
  • Eicosapentaenoic Acid* / pharmacology
  • Eicosapentaenoic Acid* / therapeutic use
  • Epicardial Adipose Tissue
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pericardium* / diagnostic imaging
  • Pericardium* / drug effects
  • Pericardium* / pathology
  • Plaque, Atherosclerotic* / diagnostic imaging
  • Plaque, Atherosclerotic* / drug therapy
  • Plaque, Atherosclerotic* / pathology
  • Triglycerides / blood
  • Waist Circumference* / drug effects

Substances

  • Eicosapentaenoic Acid
  • Docosahexaenoic Acids
  • Triglycerides