The impact of epicardial adipose tissue quantification by computed tomography on predicting postoperative outcomes in coronary artery bypass grafting surgery.

PURPOSE: Epicardial adipose tissue (EAT) modulates cardiovascular risk, but its surgical implications remain unclear. We investigated whether CT-quantified EAT predicts postoperative outcomes in isolated coronary artery bypass grafting (CABG) patients.

METHODS

This retrospective study analysed isolated CABG patients (2017-2024) with preoperative CT. EAT volume and thickness were measured using semi-automated segmentation. Primary endpoints were correlation of EAT with postoperative clinical outcomes; sternal wound infection, renal insufficiency, cerebrovascular events, postoperative atrial fibrillation (POAF) and other cardiac arrhythmias, and short- and medium-term mortality.

RESULTS

The study included 325 patients. EAT volume > 108 cm³ predicted sternal wound infection (AUC = 0.632, 62.5% sensitivity, 63.5% specificity; p = 0.0135). EAT thickness > 30.5 mm correlated with 30-day mortality (AUC = 0.650, p = 0.0428). No association with POAF was observed (p = 0.21).

CONCLUSIONS

Quantification of EAT in CABG patients may be a prognostic marker, especially providing risk assessment regarding postoperative sternal infection and short- term mortality.