Epicardial Adipose Tissue, Coronary Plaque Progression, and Major Adverse Cardiovascular Events

doi:10.1016/j.jcmg.2026.02.003

Coronary disease & ACSCohort study

Epicardial Adipose Tissue, Coronary Plaque Progression, and Major Adverse Cardiovascular Events

JACC Cardiovasc ImagingPublished 10 Mar 2026

Registry-based cohort study
serial coronary CT angiography

Read the original article ↗

Authors' conclusion

High EATv is independently associated with CAD presence and progression

Study context

Population: Patients with serial coronary CT angiography in the PARADIGM registry324 women [43%]
Participants: 773 patients

Exposure: Epicardial adipose tissue (EAT) volume tertiles
Outcome: Association of EAT volume with plaque, plaque progression (PP) and rapid plaque progression (RPP; annual PAV increase ≥1%)

Main finding

As reported in the abstract

Prevalence of PP and RPP across EATv tertiles

PP

P = 0.013

T178.9%

T283.9%

T388.5%

RPP

P = 0.021

T125.2%

T232.3%

T336.4%

Observational data: associations, not effects.

Further findings

Outcome	Values	P value
EATv by CAD presence	CAD 95 (IQR 72.5–127) cm3 · No CAD 83.5 (IQR 63–112.8) cm3	P < 0.001
Progression of PV, PAV, calcified and noncalcified plaque, T3 vs T1 — T3 vs T1 · PV		P = 0.001
Progression of PV, PAV, calcified and noncalcified plaque, T3 vs T1 — T3 vs T1 · PAV		P = 0.028
Progression of PV, PAV, calcified and noncalcified plaque, T3 vs T1 — T3 vs T1 · calcified component		P = 0.025
Progression of PV, PAV, calcified and noncalcified plaque, T3 vs T1 — T3 vs T1 · noncalcified component		P = 0.022

Progression of plaque volume (PV), percent atheroma volume (PAV), calcified and noncalcified plaque, T3 vs T1

Significantly greater progression in T3 than T1

10-year major adverse cardiovascular events (MACE)-free survival by plaque progression (PP) and rapid plaque progression (RPP)

Lower MACE-free survival with PP (log-rank): P = 0.006
Lower MACE-free survival with RPP (log-rank): P < 0.001

Original publication

Epicardial Adipose Tissue, Coronary Plaque Progression, and Major Adverse Cardiovascular Events. JACC Cardiovasc Imaging. Published 10 March 2026. doi:10.1016/j.jcmg.2026.02.003

Read the original article ↗PubMedCite RIS · BibTeX

Summarised from the published abstract; every number is checked against it