The Epicardial Adipose Tissue (EAT) is related to both the early development of atherosclerosis and the severity of coronary artery disease (CAD). We aimed to assess the influence of the EAT volume which was measured by cardiac magnetic resonance imaging (CMR) on infarct size and on clinical outcomes in acute ST-elevation myocardial infarction (STEMI) with successful reperfusion.

This prospective study involved 193 patients with a first STEMI admitted to the University Hospital of Angers. CMR was performed at baseline and after a three-month follow-up in order to investigate common CMR findings, such as left ventricular (LV) volumes, ejection fraction (EF), infarct size, micro-vascular obstruction (MVO), systolic wall stress (SWS) and EAT volume. We divided the population into quartiles – the greater quartile of EAT defining the high EAT group (>33.5ml). Clinical outcomes were recorded during the index hospitalization and a 1-year follow-up.

Patients in high EAT group were significantly associated with increased body mass index and hypertension, presented a smaller infarct size (18.3±11.9 vs 23±13.7% of total LV, p=0.041) at initial CMR assessment and after a 3-month follow-up (p=0.01), MVO occurred less frequently (36.2 vs 59.3%, p=0.006). We found no difference between EAT groups in regard to LVEF, LV volumes, SWS as well as in regard to coronary burden and clinical events during the index hospitalization or the follow-up. EAT was an independent predictor of low infarct size in univariate and multivariate analysis; B=–3.25 [–5.894; –0.615], p=0.016.Fig. 1

EAT volume > 33.5ml was paradoxically related to smaller infarct size in STEMI but didn’t seem to be related to changes in LVEF, LV remodelling or further clinical events.

The author hereby declares no conflict of interest