Mauricio Sarmiento-Cobos, MD, Lisandro Montorfano, MD, Carlos Rivera, MD, Camila Ortiz Gomez, Elliot Wasser, MD, Emanuele Lo Menzo, MD, PhD, FACS, FASMBS, Samuel Szomstein, MD, FACS, FASMBS, Raul Rosenthal, MD, FACS, FASMBS. Cleveland Clinic Florida
BACKGROUND: Pericardial fat is a type of visceral adipose tissue (VAT) with multiple endocrine and inflammatory functions, which may play an important role in the pathogenesis of coronary artery disease. Due to its anatomical location, it has been associated with vulnerability of the atherosclerotic plaque. Lipid-lowering therapy has been shown to halt the progression of atherosclerotic plaques and to induce regression of cardiac adipose tissue. The aim of this study is to report the statin effect on pericardial fat after bariatric surgery.
METHODS: A linear measurement of the pericardial fat thickness (PFt) was recorded before and after Bariatric Surgery (BS), from the chest and abdominal CT scans. We divide the patients into two groups; patients using statins (Group 1), and patients not using statins (Group 2). PFt was measured in both groups at the right ventricular wall, perpendicular to the myocardium, at the level of the sternum. We compared the measurements before and after BS, and the risk of developing CAD by Framingham heart study. Common demographics and comorbidities were collected along with lipid profile preoperative and postoperative and were analyzed between the groups.
RESULTS: From our bariatric population, 82 patients met inclusion criteria. We identified 31 patients in Group 1 and 51 patients in Group 2. In group one 41.93% (n=13) and in group 2 70.58% (n=36) were females. The average age for group one was 61.35 + 11.14 years and 57.27 + 9.001 years for group two (p=0.091). The percentage of estimated BMI loss (EBMIL)% at 12 months in group one was 57.32 + 31.08 (N=28) versus 73.30 + 31.16 (N=42) in group two (p=0.04). Pericardial fat thickness loss was 17.07 + 10.86% in group one versus 11.78 + 6.35 % in group 2. The risk of CAD one year after BS was 12.22 + 6.57 (n=9), and in group two was 6.78 + 2.38 (n=9) p=0.04.
CONCLUSION: Obese patients have higher VAT deposits. Pericardial adipose tissue is highly associated with the risk of developing CAD. Pericardial fat can be a target by pharmaceutical agents like statins. In our population, the use of statins combined with bariatric surgery is linked to a significant decrease in pericardial fat thickness and to a lower risk of CAD. Further studies may be needed to better assess these findings.
Table 1. Variables and Demographics.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95251
Program Number: P160
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster