Epicardial Adipose Tissue Changes during Statin Administration in Relation to the Body Mass Index: A Longitudinal Cardiac CT Study

The epicardial adipose tissue (EAT) is the visceral fat located between the myocardium and the pericardium. We aimed to perform a longitudinal evaluation of the epicardial adipose tissue using an advanced computer-assisted approach in a population of patients undergoing Cardiac CT (CCT) during statin administration, in relation to their body mass index (BMI). We retrospectively enrolled 95 patients [mean age 62 ± 10 years; 68 males (72%) and 27 females (28%)] undergoing CCT for suspected coronary artery disease during statin administration. CCT was performed at two subsequent time points. At the second CCT, EAT showed a mean density increase (-75.59 ± 7.0 HU vs. -78.18 ± 5.3 HU, p < 0.001) and a volume decrease (130 ± 54.3 cm3 vs.142.79 ± 56.9 cm3, p < 0.001). Concerning coronary artery EAT thickness, a reduction was found at the origin of the right coronary artery (13.26 ± 5.2 mm vs. 14.94 ± 5.8, p = 0.001) and interventricular artery (8.22 ± 3.7 mm vs. 9.13 ± 3.9 mm, p = 0.001). The quartile (Q) attenuation percentage (%) distribution of EAT changed at the second CCT. The EAT % distribution changed by the BMI in Q1 (p = 0.015), Q3 (p = 0.001) and Q4 (p = 0.043) at the second CCT, but the normal-BMI and over-weight/obese patients showed a similar response to statin therapy in terms of quartiles distribution changes. In conclusion, statins may determine significant changes in EAT quantitative and qualitative characteristics detected by CCT; the BMI influences the EAT composition, but statins determine a similar response in quartile distribution's variation, irrespective of the BMI.