Pericardial adipose tissue and coronary artery calcification in the Multi‐ethnic Study of Atherosclerosis (MESA)

Objective: To examine the relationship of pericardial adipose tissue (PAT) with coronary artery calcification in the Multi‐Ethnic Study of Atherosclerosis. Design and Methods: The baseline cohort comprised 6,814 Caucasian (38%), African‐American (28%), Chinese American (12%), and Hispanic (22%) adults aged 45‐84, without known clinical cardiovascular disease. Cardiac CT was used to measure PAT (cm 3 ) and calcification (Agatston score). We examined cross‐sectional associations of PAT with the presence (score >0) and severity (continuous score if >0) of calcification using prevalence ratio (PR) ( n = 6,672) and linear regression ( n = 3,362), respectively. Main models were adjusted for age, age 2 , gender, race/ethnicity, field site, smoking, physical activity, alcohol, and education. Results: PAT volume (adjusted for age, height, weight, and site) was greatest in Chinese males, whereas Black males had less PAT than all but Black females. PAT was associated with presence [PR per standard deviation (SD): 1.06 (95% CI: 1.04, 1.08)] and severity [difference in log Agatston score per SD: 0.15 (0.09, 0.21)] of calcification, but neither association varied by race/ethnicity. Adjustment for generalized adiposity attenuated but did not eliminate the associations. With further adjustment for traditional risk factors and inflammatory markers, only the association with severity remained statistically significant [PR: 1.02 (1.00, 1.04); difference: 0.10 (0.03, 0.17)]. Heterogeneity by sex was observed for the presence of calcification (PR in men: 1.04; in women: 1.08; P for interaction <0.0001). Conclusion: PAT was associated with the presence and severity of coronary artery calcification in this cohort, but neither association varied by race/ethnicity.