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Association between epicardial adipose tissue thickness and coronary heart disease: A metaanalysis

Yuan Shuai, Ai Ke-Qing,Yang Xin-Quan, Xiong Ting, Zhang Rong, Han Xiao, Li Jia-Jing, Zhang Shu-Meng, Zhao Fei-Fei, Wang Fang, Xiao Yuan-Yuan, Gong Yu-Nan, Lu Kai, Liu Yuan, Li Qi, Ren Yan-Xia, Qian Zhi Min, Sun Chao, Liang Jia-Yang, Xu Bao1,2, Zhang Zhu1,2, Yin Hui-Jiao1,2, Li Xiao-Du1,2, Mao Yu-Lin2, Huang Liu-ai1,2, Yue Jian, He Sheng-Hu and Wang Da-Xin*

Objective: To systematically evaluate the efficacy and diagnostic value of epicardial adipose tissue in coronary artery disease. Methods: The authors searched PubMed, Embase, Web of Science, CNKI and CBM from the database to January 2019, and collected articles on the clinical trials of epicardial adipose tissue in coronary heart disease. The improved Jadad scale was used for quality evaluation, and Revman 5.3 software was used for metaanalysis of the included literature. Results: Finally, 21 articles were included, including a total of 4049 patients. EAT was 12.21 2.62 mm in the CAD group and 9.92 1.37 mm in the non-CAD group. EAT was 2.22 1.86 mm in the CAD group and 1.8 1.4 mm in the non-CAD group. The random effect model was adopted for the study (I2=95%, p<0.00001, Q=398.94, df [Q]=20), and heterogeneity was found in all cases. The EAT of CAD patients was significantly higher than that of non-CAD patients (SMD=1.07, 95% CI=0.75-1.38, p<0.00001). EAT of CAD patients in echocardiography group and CT measurement group was higher than that of non-CAD patients. Conclusion: According to the results of this meta-analysis, EAT in patients undergoing echocardiography or CT examination has certain value in the diagnosis and risk stratification of coronary artery disease due to its ease-of-use, cost-effectiveness and non-exposure characteristics, and is worthy of further clinical exploration.