Ueyama Chikara, Horibe Hideki, Maekawa Yasutaka, Hiramatsu Shotaro, Yamase Yuichiro, Funabiki Junya, Takemoto Yoshio, Shigeta Toshimasa, Hibino Takeshi, Kondo Taizo, Yatsuya Hiroshi, Ishii Hideki, Murohara Toyoaki
Department of Cardiovascular Medicine, Gifu Prefectural Tajimi Hospital, 5-161 Maebata-Cho, Tajimi, 507-8522, Japan.
Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Heart Vessels. 2025 May 26. doi: 10.1007/s00380-025-02557-z.
Abdominal visceral adipose tissue (AVAT) is associated with the incidence of cardiovascular events (CVEs). We retrospectively evaluated the association between AVAT and the incidence of CVEs in 602 patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI). Patients were divided into four groups according to the quartiles of AVAT areas using computed tomography. The incidence of CVEs (cardiovascular death, ACS recurrence and stroke) during the follow-up period (median 49.5 months) was evaluated. Cox analysis adjusting for cardiovascular risk factors revealed that the AVAT quartile classification exhibited a significant association with the incidence of CVEs. The risk in quartile 3 (moderate AVAT areas, ≥ 106.0 to < 142.6 cm) was significantly lower than in quartiles 1 (low AVAT areas, < 71.0cm; P < 0.01; hazard ratio [HR], 5.06), 2 (mild AVAT areas, ≥ 71.0 to < 106.0 cm; P < 0.01; HR, 4.25) and 4 (severe AVAT areas, ≥ 142.6 cm; P < 0.01; HR, 4.52). Polynomial analyses revealed that quadratic model was the most appropriate to illustrate the relationship between AVAT area and the hazard ratios for CVEs (corrected Akaike's information criterion, 49.2; R, 0.47). The AVAT area and the incidence of CVEs exhibited a U-shaped relationship in patients with ACS undergoing PCI independent of conventional cardiovascular risk factors. The risk of CVEs was the lowest in patients with moderate AVAT areas. Evaluating AVAT may provide additional information for the assessment of long-term prognosis in patients with ACS.
腹部内脏脂肪组织（AVAT）与心血管事件（CVE）的发生率相关。我们回顾性评估了602例行经皮冠状动脉介入治疗（PCI）的急性冠状动脉综合征（ACS）患者中AVAT与CVE发生率之间的关联。使用计算机断层扫描根据AVAT面积的四分位数将患者分为四组。评估随访期（中位数49.5个月）内CVE（心血管死亡、ACS复发和中风）的发生率。对心血管危险因素进行校正的Cox分析显示，AVAT四分位数分类与CVE发生率存在显著关联。第3四分位数（中等AVAT面积，≥106.0至＜142.6 cm）的风险显著低于第1四分位数（低AVAT面积，＜71.0 cm；P＜0.01；风险比[HR]，5.06）、第2四分位数（轻度AVAT面积，≥71.0至＜106.0 cm；P＜0.01；HR，4.25）和第4四分位数（重度AVAT面积，≥142.6 cm；P＜0.01；HR，4.52）。多项式分析显示，二次模型最适合说明AVAT面积与CVE风险比之间的关系（校正的赤池信息准则，49.2；R，0.47）。在接受PCI的ACS患者中，AVAT面积与CVE发生率呈U形关系，独立于传统心血管危险因素。中等AVAT面积患者的CVE风险最低。评估AVAT可能为评估ACS患者的长期预后提供额外信息。
