AI-quantified epicardial adipose tissue and prediction of future myocardial infarction in patients with cardiometabolic disease: a post-hoc analysis from the SCOT-HEART trial
Authors' conclusion
CT-derived Epicardial adipose tissue volume correlates with quantitative and high-risk plaque features, and independently predicts risk of myocardial infarction in patients with cardiometabolic disease.
Study context
- Population
- Patients with suspected coronary artery disease, with or without cardiometabolic disease (SCOT-HEART); 58 ± 9 years, 56% males
- Participants
- 1,770 patients
- Comparison
- Epicardial adipose tissue volume and attenuation vs coronary plaque features and MI risk
- Cardiometabolic diseasen = 313
- Primary endpoint
- Fatal or non-fatal MI
- Follow-up
- Median 8.6 years
Methodological detailspost-hoc analysis, deep-learning quantification of epicardial adipose tissue
- Post-hoc analysis
- Deep-learning quantification of epicardial adipose tissue
Primary result
As reported in the abstract
Patients with MI, total cohort
82
4.6%
Further findings
Epicardial adipose tissue volume by cardiometabolic disease · higher with cardiometabolic disease
P < 0.001
- Epicardial adipose tissue volume by coronary calcium score — Increased with calcium score
- p < 0.001
- Epicardial adipose tissue volume by low-attenuation plaque burden — Increased with low-attenuation plaque burden
- p < 0.001
- Epicardial adipose tissue volume by coronary calcium score: Calcium score 0 mean 82 ± 35 mL
- Epicardial adipose tissue volume by coronary calcium score: Calcium score 1-400 mean 97 ± 38 mL
- Epicardial adipose tissue volume by coronary calcium score: Calcium score > 400 mean 113 ± 44 mL
- Epicardial adipose tissue volume by low-attenuation plaque burden: Burden ≤ 4% mean 85 ± 36 mL
- Epicardial adipose tissue volume by low-attenuation plaque burden: Burden > 4% mean 103 ± 41 mL
Epicardial adipose tissue attenuation
- No interactions between these features and epicardial adipose tissue attenuation
- P > 0.05 for all
Original publication
AI-quantified epicardial adipose tissue and prediction of future myocardial infarction in patients with cardiometabolic disease: a post-hoc analysis from the SCOT-HEART trial. Cardiovasc Diabetol. Published 22 October 2025. doi:10.
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