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Cardiology. 2013;124(1):41-8. doi: 10.1159/000345298. Epub 2013 Jan 11.

Relation of epicardial fat thickness and cardio-ankle vascular index to complexity of coronary artery disease in nondiabetic patients.

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Department of Cardiology, Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey.



Arterial stiffness and epicardial fat thickness (EFT) are associated with coronary artery disease (CAD). The cardio-ankle vascular index (CAVI) is a novel marker of arterial stiffness. The SYNTAX score (SS) reflects the complexity of CAD. We aimed to evaluate the relation of EFT and CAVI with CAD complexity in nondiabetic patients.


We enrolled 121 patients undergoing coronary angiography. In all patients, CAVI and EFT were determined. SS were calculated. The relationship between EFT, CAVI and SS was analyzed.


CAVI and EFT were significantly correlated with SS (r = 0.537, p < 0.001, and r = 0.629, p < 0.001, respectively) and found to be independent predictors of intermediate-high SS. For the prediction of intermediate-high SS, receiver-operating characteristic curve analysis revealed a cutoff value of 5 mm for EFT (area under the curve, AUC = 0.851, 95% confidence interval, CI, 0.775-0.910) with a specificity of 92.2% and a sensitivity of 77.4% and 8.6 for CAVI (AUC = 0.877, 95% CI 0.805-0.929) with a specificity of 68.9% and a sensitivity of 93.5%.


CAD complexity is associated with adverse cardiovascular events. It can be predicted noninvasively with EFT and CAVI in nondiabetic patients with suspected CAD. Thus, patients at high risk for cardiovascular events may be detected early and managed with appropriate treatment strategies.

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