Loading ...

TOPLINE:

The volume of epicardial adipose tissue was independently associated with new-onset atrial fibrillation (AF) in individuals without a history of the condition. Patients with the highest volumes of fatty tissue were more than twice as likely to develop AF as those with the lowest volumes.

METHODOLOGY:

• Researchers examined the association between the volume of epicardial adipose tissue and the incidence of AF in a general population cohort from the greater Copenhagen area.
• The researchers included 2292 participants aged 40 years or older (mean age, 59.4; 54% women) with no prior history of AF and normal kidney function.
• The participants underwent cardiac CT angiography of the volume of epicardial adipose tissue. The scans were quantified and categorized into quartiles.
• The primary endpoint was new-onset AF, and the secondary endpoint was all-cause mortality, assessed over a median follow-up duration of 7.7 years.

TAKEAWAY:

• Overall, 123 participants (5.4%) developed AF, corresponding to an incidence rate of 7.2 per 1000 person-years.
• Each standard deviation increase in the volume of epicardial adipose tissue was associated with a 29% higher risk for AF (adjusted hazard ratio, 1.29; P = .01).
• The absolute risk for AF increased from 4.6% in the lowest quartile of epicardial adipose tissue volume to 11.4% in the highest quartile (Gray test P < .001), with no significant differences in cumulative risk for mortality.
• The volume of epicardial adipose tissue was associated with age, male sex, BMI, alcohol consumption, smoking status, and the presence of chronic obstructive pulmonary disease (P < .05).

IN PRACTICE:

“These findings indicate that traditional measures like BMI may not fully reflect the AF risk associated with EAT [epicardial adipose tissue],” the researchers reported. Because that tissue “is potentially modifiable through weight loss and pharmacologic interventions, identifying it as a risk factor offers an opportunity for early prevention strategies,” they added.

SOURCE:

This study was led by Jonas Jalili Pedersen, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark. It was published online on July 31, 2025, in the European Heart Journal.

LIMITATIONS:

Participants who opted for research CT angiography scans may have differed from the general population, introducing healthy volunteer bias. The incidence of AF may have been underestimated, as episodes of asymptomatic or paroxysmal AF may have remained undetected. This observational study did not imply that AF was caused by high epicardial adipose tissue.

DISCLOSURES:

The primary researcher received support through a grant from the Novo Nordisk Foundation. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.