Predictive Value of Epicardial Adipose Tissue Thickness for Plaque Vulnerability in Left Coronary Arteries: Histological Evidence from 245 Sudden Cardiac Death Cases

<b>Background/Objectives:</b> Cardiovascular disease remains the leading global cause of death, with atherosclerotic plaque vulnerability, rather than stenosis severity, playing a central role in acute coronary events. Epicardial adipose tissue (EAT) has emerged as a key contributor to c...

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Main Authors: Raluca Niculescu, Alexandru Mureșan, Carmen Corina Radu, Timur Robert Hogea, Iuliu Gabriel Cocuz, Adrian Horațiu Sabău, Eliza Russu, Emil Marian Arbănași, Eliza Mihaela Arbănași, Adrian Vasile Mureșan, Adina Stoian, Daniela Edith Ceană, Corneliu Florin Buicu, Ovidiu Simion Cotoi
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Language:English
Published: MDPI AG 2025-06-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/12/1491
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author Raluca Niculescu
Alexandru Mureșan
Carmen Corina Radu
Timur Robert Hogea
Iuliu Gabriel Cocuz
Adrian Horațiu Sabău
Eliza Russu
Emil Marian Arbănași
Eliza Mihaela Arbănași
Adrian Vasile Mureșan
Adina Stoian
Daniela Edith Ceană
Corneliu Florin Buicu
Ovidiu Simion Cotoi
author_facet Raluca Niculescu
Alexandru Mureșan
Carmen Corina Radu
Timur Robert Hogea
Iuliu Gabriel Cocuz
Adrian Horațiu Sabău
Eliza Russu
Emil Marian Arbănași
Eliza Mihaela Arbănași
Adrian Vasile Mureșan
Adina Stoian
Daniela Edith Ceană
Corneliu Florin Buicu
Ovidiu Simion Cotoi
author_sort Raluca Niculescu
collection DOAJ
description <b>Background/Objectives:</b> Cardiovascular disease remains the leading global cause of death, with atherosclerotic plaque vulnerability, rather than stenosis severity, playing a central role in acute coronary events. Epicardial adipose tissue (EAT) has emerged as a key contributor to coronary atherosclerosis and myocardial ischemia. This study aimed to investigate the relationship between EAT thickness and the development and severity of atherosclerotic plaques in these coronary arteries, and to evaluate the influence of demographic factors on EAT thickness and plaque vulnerability. <b>Methods</b>: A retrospective analysis was conducted on autopsy data from 245 sudden cardiac death (SCD) cases (2021–2023). EAT thickness was measured at the left anterior descending artery (LAD) and left circumflex coronary artery (LCx) levels. From each artery, one segment that showed evidence of an atherosclerotic plaque was collected and sent for histological examination. Additionally, we documented demographic data, including age, sex, and body mass index (BMI) for each case. <b>Results</b>: In the present study, we enrolled 245 subjects with SCD, among whom 175 (71.42%) were male, and 70 (28.58%) were female. The mean age was 62.31 ± 12.69 years, and the mean BMI was 26.12 ± 4.16. We observed a mean EAT thickness value of 0.74 ± 0.26 cm at the LAD artery level and 0.71 ± 0.27 cm at the LCx artery level. We observed a positive correlation between BMI and EAT thickness at the LAD level (r = 0.260, <i>p</i> < 0.001) and similarly at the LCx level (r = 0.260, <i>p</i> < 0.001). Additionally, advancing age is associated with an increase in EAT thickness at both the LAD level (r = 0.188, <i>p</i> = 0.003) and the LCx level (r = 0.242, <i>p</i> < 0.001). Furthermore, we observed a higher EAT thickness at the LAD level (<i>p</i> = 0.0019) and the LCx level (<i>p</i> = 0.0225) among subjects with unstable atherosclerotic plaques. In the logistic regression analysis, the elevated value of EAT thickness was associated with unstable atherosclerotic plaque at LAD (OR: 1.88, <i>p</i> = 0.002) and LCx (OR: 1.51, <i>p</i> = 0.010) for the entire study cohort. <b>Conclusions</b>: Our data revealed that higher baseline values of EAT LCx and EAT LAD are associated with unstable plaque at the level of the left coronary arteries. Furthermore, our findings indicate that male individuals are more susceptible to developing unstable plaques in the coronary arteries.
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spelling doaj-art-3b5e9983486742d88d77bf5716ae706d2025-08-20T03:27:28ZengMDPI AGDiagnostics2075-44182025-06-011512149110.3390/diagnostics15121491Predictive Value of Epicardial Adipose Tissue Thickness for Plaque Vulnerability in Left Coronary Arteries: Histological Evidence from 245 Sudden Cardiac Death CasesRaluca Niculescu0Alexandru Mureșan1Carmen Corina Radu2Timur Robert Hogea3Iuliu Gabriel Cocuz4Adrian Horațiu Sabău5Eliza Russu6Emil Marian Arbănași7Eliza Mihaela Arbănași8Adrian Vasile Mureșan9Adina Stoian10Daniela Edith Ceană11Corneliu Florin Buicu12Ovidiu Simion Cotoi13Department of Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, RomaniaClinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, RomaniaDepartment of Forensic Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, RomaniaDepartment of Forensic Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, RomaniaDepartment of Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, RomaniaDepartment of Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, RomaniaDepartment of Vascular Surgery, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, RomaniaDoctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, RomaniaDoctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, RomaniaDepartment of Vascular Surgery, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, RomaniaDepartment of Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, RomaniaDepartment of Public Health, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, RomaniaDepartment of Public Health, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, RomaniaDepartment of Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania<b>Background/Objectives:</b> Cardiovascular disease remains the leading global cause of death, with atherosclerotic plaque vulnerability, rather than stenosis severity, playing a central role in acute coronary events. Epicardial adipose tissue (EAT) has emerged as a key contributor to coronary atherosclerosis and myocardial ischemia. This study aimed to investigate the relationship between EAT thickness and the development and severity of atherosclerotic plaques in these coronary arteries, and to evaluate the influence of demographic factors on EAT thickness and plaque vulnerability. <b>Methods</b>: A retrospective analysis was conducted on autopsy data from 245 sudden cardiac death (SCD) cases (2021–2023). EAT thickness was measured at the left anterior descending artery (LAD) and left circumflex coronary artery (LCx) levels. From each artery, one segment that showed evidence of an atherosclerotic plaque was collected and sent for histological examination. Additionally, we documented demographic data, including age, sex, and body mass index (BMI) for each case. <b>Results</b>: In the present study, we enrolled 245 subjects with SCD, among whom 175 (71.42%) were male, and 70 (28.58%) were female. The mean age was 62.31 ± 12.69 years, and the mean BMI was 26.12 ± 4.16. We observed a mean EAT thickness value of 0.74 ± 0.26 cm at the LAD artery level and 0.71 ± 0.27 cm at the LCx artery level. We observed a positive correlation between BMI and EAT thickness at the LAD level (r = 0.260, <i>p</i> < 0.001) and similarly at the LCx level (r = 0.260, <i>p</i> < 0.001). Additionally, advancing age is associated with an increase in EAT thickness at both the LAD level (r = 0.188, <i>p</i> = 0.003) and the LCx level (r = 0.242, <i>p</i> < 0.001). Furthermore, we observed a higher EAT thickness at the LAD level (<i>p</i> = 0.0019) and the LCx level (<i>p</i> = 0.0225) among subjects with unstable atherosclerotic plaques. In the logistic regression analysis, the elevated value of EAT thickness was associated with unstable atherosclerotic plaque at LAD (OR: 1.88, <i>p</i> = 0.002) and LCx (OR: 1.51, <i>p</i> = 0.010) for the entire study cohort. <b>Conclusions</b>: Our data revealed that higher baseline values of EAT LCx and EAT LAD are associated with unstable plaque at the level of the left coronary arteries. Furthermore, our findings indicate that male individuals are more susceptible to developing unstable plaques in the coronary arteries.https://www.mdpi.com/2075-4418/15/12/1491epicardial adipose tissue (EAT)sudden cardiac death (SCD)unstable plaquebiomarkersautopsy
spellingShingle Raluca Niculescu
Alexandru Mureșan
Carmen Corina Radu
Timur Robert Hogea
Iuliu Gabriel Cocuz
Adrian Horațiu Sabău
Eliza Russu
Emil Marian Arbănași
Eliza Mihaela Arbănași
Adrian Vasile Mureșan
Adina Stoian
Daniela Edith Ceană
Corneliu Florin Buicu
Ovidiu Simion Cotoi
Predictive Value of Epicardial Adipose Tissue Thickness for Plaque Vulnerability in Left Coronary Arteries: Histological Evidence from 245 Sudden Cardiac Death Cases
Diagnostics
epicardial adipose tissue (EAT)
sudden cardiac death (SCD)
unstable plaque
biomarkers
autopsy
title Predictive Value of Epicardial Adipose Tissue Thickness for Plaque Vulnerability in Left Coronary Arteries: Histological Evidence from 245 Sudden Cardiac Death Cases
title_full Predictive Value of Epicardial Adipose Tissue Thickness for Plaque Vulnerability in Left Coronary Arteries: Histological Evidence from 245 Sudden Cardiac Death Cases
title_fullStr Predictive Value of Epicardial Adipose Tissue Thickness for Plaque Vulnerability in Left Coronary Arteries: Histological Evidence from 245 Sudden Cardiac Death Cases
title_full_unstemmed Predictive Value of Epicardial Adipose Tissue Thickness for Plaque Vulnerability in Left Coronary Arteries: Histological Evidence from 245 Sudden Cardiac Death Cases
title_short Predictive Value of Epicardial Adipose Tissue Thickness for Plaque Vulnerability in Left Coronary Arteries: Histological Evidence from 245 Sudden Cardiac Death Cases
title_sort predictive value of epicardial adipose tissue thickness for plaque vulnerability in left coronary arteries histological evidence from 245 sudden cardiac death cases
topic epicardial adipose tissue (EAT)
sudden cardiac death (SCD)
unstable plaque
biomarkers
autopsy
url https://www.mdpi.com/2075-4418/15/12/1491
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