coronary artery calcification

Study: Paracardial Fat Significantly Increases CVD Risk in Older Women

Higher volumes of paracardial adipose tissue (PAT) is associated with a significantly increased risk of heart disease in women following menopause and women with lower estrogen levels at midlife, according to the results of a recent study.1

Previous research has shown that volumes of PAT and epicardial adipose tissue (EAT) increase following menopause.2 However, PAT, but not EAT, is associated with estradiol decline, suggesting that menopause could play a role in PAT accumulation.
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For this reason, researchers conducted a study to determine whether EAT or PAT were associated with coronary artery calcification (CAC) in women at midlife and whether menopausal status effected estradiol levels.

Clinical data—including blood samples and heart CT scans—from 478 women of varying stages of menopause enrolled in the Study of Women’s Health Across the Nation was assessed by the researchers for their study, which was built upon the results of a previous study by the same team that found that greater volumes of PAT after menopause was associated with declines in estradiol levels.

Overall, EAT was significantly associated with CAC measures, but the association was not modified by menopausal status. However, associations between PAT and CAC were modifiable by menopausal status, with each 1-SD unit increase in log PAT being associated with a 102% higher risk of CAC presence and an 80% increase in CAC extent in postmenopausal women compared with pre- and early perimenopausal women.

“The findings suggest that PAT is a potential menopause‐specific coronary artery disease risk marker, supporting the need to monitor and target this fat depot for intervention in women at midlife,” the researchers concluded.

—Michael Potts

Reference:

  1. El Khoudary SR, Shields KJ, Janssen I, et al. Postmenopausal women with greater paracardial fat have more coronary artery calcification than premenopausal women: the study of women's health across the nation (SWAN) cardiovascular fat ancillary study [published online January 29, 2017]. JAHA. doi:https://doi.org/10.1161/JAHA.116.004545.
  2. El Khoudary SR, Shields KJ, Janssen I, et al. Cardiovascular fat, menopause, and sex hormones in women: the SWAN Cardiovascular Fat Ancillary Study. J Clin Endocrinol Metab. 2015;100:3304–3312.