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September 3, 2026Journal of Cardiovascular Development and DiseaseOpen Access

CT-derived EAT volume fails to improve CAD discrimination beyond conventional risk factors in adults ≥80 years.

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Why the study?

Does CT-derived EAT volume improve discrimination of CAD in patients aged ≥80 years?

Population

155 patients aged ≥80 years who underwent coronary imaging evaluation between 2020 and 2022, of whom 45 had…

Comparison

Computed tomography-derived epicardial adipose… vs Conventional clinical risk factors alone

Design

Cohort

Key result

CT-derived epicardial adipose tissue volume did not improve discrimination for coronary artery disease beyond conventional risk factors in adults aged ≥80 years (AUC 0.698 vs. 0.697; P=0.945).

Authors

JLJingyi LiZZZiwei ZhuXNXuefeng Ni

Discussion

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Overview

EAT volume adds no CAD discrimination value in patients ≥80 years; leaves open its utility in younger cohorts or for other endpoints.

Key Points

  • To assess whether computed tomography-derived epicardial adipose tissue (EAT) volume provides incremental value for discriminating coronary artery disease (CAD) in adults aged 80 years and older.
  • Retrospectively analyzed 155 patients aged ≥80 years who underwent coronary imaging evaluation between 2020 and 2022.
  • Quantified total EAT volume from non-contrast chest computed tomography scans.
  • Evaluated CAD discrimination and feature importance using multivariable logistic regression, CatBoost machine learning, and SHapley Additive exPlanations (SHAP).
  • Among 155 patients, 45 (29.0%) had CAD, and median EAT volume did not differ significantly between CAD and non-CAD groups (p = 0.716).
  • Adding EAT volume did not improve CAD discrimination in logistic regression (AUC 0.698 vs. 0.697; likelihood-ratio p = 0.945) or cross-validated CatBoost analysis (AUC 0.623 vs. 0.614).
  • SHAP analysis ranked EAT 8th out of 18 predictors, placing it below standard risk factors including lipoprotein(a), total cholesterol, left atrial diameter, and HbA1c.

Study Design

Type

Observational (n=155)

Structured PICO

Does CT-derived EAT volume improve discrimination of CAD in patients aged ≥80 years?

P
Population
155 patients aged ≥80 years who underwent coronary imaging evaluation to assess the association of epicardial adipose tissue volume with coronary artery disease.
E
Exposure
Computed tomography (CT)-derived epicardial adipose tissue (EAT) volume added to conventional clinical risk factors
C
Comparator
Conventional clinical risk factors alone
O
Outcome
Discrimination of coronary artery disease (CAD) measured by area under the curve (AUC)surrogate

Main Result

Absolute Event Rate: 0.698% vs 0.697%

p-value: p=0.945

CT-derived epicardial adipose tissue volume does not provide incremental value over conventional risk factors for discriminating coronary artery disease in patients aged 80 years and older.

Cite This Study

Li et al. (2026) conducted an observational in Coronary artery disease (n=155). Epicardial adipose tissue volume vs. Conventional clinical risk factors was evaluated on Discrimination of coronary artery disease (AUC) (p=0.945). CT-derived epicardial adipose tissue volume did not improve discrimination for coronary artery disease beyond conventional risk factors in adults aged ≥80 years (AUC 0.698 vs. 0.697; P=0.945).

synapsesocial.com/papers/6a99355b636c6408cfa7d7e2https://doi.org/10.3390/jcdd13090424
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