{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T06:43:56Z","timestamp":1780469036800,"version":"3.54.1"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,2,2]]},"abstract":"\n Background<\/jats:title>\n \n Volumes of paracardial adipose tissue (\n PAT<\/jats:styled-content>\n ) and epicardial adipose tissue (\n EAT<\/jats:styled-content>\n ) are greater after menopause. Interestingly,\n PAT<\/jats:styled-content>\n but not\n EAT<\/jats:styled-content>\n is associated with estradiol decline, suggesting a potential role of menopause in\n PAT<\/jats:styled-content>\n accumulation. We assessed whether volumes of heart fat depot (\n EAT<\/jats:styled-content>\n and\n PAT<\/jats:styled-content>\n ) were associated with coronary artery calcification (\n CAC<\/jats:styled-content>\n ) in women at midlife and whether these associations were modified by menopausal status and estradiol levels.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n EAT<\/jats:styled-content>\n and\n PAT<\/jats:styled-content>\n volumes and\n CAC<\/jats:styled-content>\n were measured using electron beam computed tomography scans.\n CAC<\/jats:styled-content>\n was evaluated as (1) the presence of\n CAC<\/jats:styled-content>\n (\n CAC<\/jats:styled-content>\n Agatston score \u226510) and (2) the extent of any\n CAC<\/jats:styled-content>\n (log\n CAC<\/jats:styled-content>\n Agatston score >0). The study included 478 women aged 50.9\u00a0years (58% pre\u2010 or early perimenopausal, 10% late perimenopausal, and 32% postmenopausal).\n EAT<\/jats:styled-content>\n was significantly associated with\n CAC<\/jats:styled-content>\n measures, and these associations were not modified by menopausal status or estradiol. In contrast, associations between\n PAT<\/jats:styled-content>\n and\n CAC<\/jats:styled-content>\n measures were modified by menopausal status (interaction\u2010\n P<\/jats:italic>\n \u22640.01). Independent of study covariates including other adiposity measures, each 1\u2010SD unit increase in log\n PAT<\/jats:styled-content>\n was associated with 102% higher risk of\n CAC<\/jats:styled-content>\n presence (\n P<\/jats:italic>\n =0.04) and an 80% increase in\n CAC<\/jats:styled-content>\n extent (\n P<\/jats:italic>\n =0.008) in postmenopausal women compared with pre\u2010 or early perimenopausal women. Additional adjustment for estradiol and hormone therapy attenuated these differences. Moreover, the association between\n PAT<\/jats:styled-content>\n and\n CAC<\/jats:styled-content>\n extent was stronger in women with lower estradiol levels (interaction\n P<\/jats:italic>\n =0.004).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n The findings suggest that\n PAT<\/jats:styled-content>\n is a potential menopause\u2010specific coronary artery disease risk marker, supporting the need to monitor and target this fat depot for intervention in women at midlife.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.116.004545","type":"journal-article","created":{"date-parts":[[2017,1,31]],"date-time":"2017-01-31T01:16:42Z","timestamp":1485825402000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":44,"title":["Postmenopausal Women With Greater Paracardial Fat Have More Coronary Artery Calcification Than Premenopausal Women: The Study of Women's Health Across the Nation (SWAN) Cardiovascular Fat Ancillary Study"],"prefix":"10.1161","volume":"6","author":[{"given":"Samar R.","family":"El Khoudary","sequence":"first","affiliation":[{"name":"Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly J.","family":"Shields","sequence":"additional","affiliation":[{"name":"Lupus Center of Excellence, Autoimmunity Institute, Department of Medicine, Allegheny Health Network, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imke","family":"Janssen","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, Rush University Medical Center, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Budoff","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Los Angeles Biomedical Research Institute, Torrance, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan A.","family":"Everson\u2010Rose","sequence":"additional","affiliation":[{"name":"Department of Medicine and Program in Health Disparities Research, University of Minnesota Medical School, Minneapolis, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynda H.","family":"Powell","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, Rush University Medical Center, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen A.","family":"Matthews","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA"},{"name":"Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/0531-5565(94)90017-5"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000366"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2008.25"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/gme.0b013e318240f6f3"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1080\/13697130400012163"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/44.6.739"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/gme.0b013e31827212a5"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.10.009"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/gme.0b013e3182611787"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(03)00361-3"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/oby.20974"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11892-008-0005-2"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.743062"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2014.07.002"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehn573"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.2008.27358"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.11.062"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2015.02.022"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.05.052"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1210\/JC.2015-2110"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2011.12.004"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehm564"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.06.038"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.12.035"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/B978-012453790-3\/50012-3"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(90)90282-T"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(00)01431-4"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/24.7.1112"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-2275(20)41577-9"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/18.6.499"},{"key":"e_1_3_4_32_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00280883"},{"key":"e_1_3_4_33_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.24.2.362"},{"key":"e_1_3_4_34_2","doi-asserted-by":"publisher","DOI":"10.1006\/pmed.1998.0470"},{"key":"e_1_3_4_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tem.2011.07.003"},{"key":"e_1_3_4_36_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.97.23.12729"},{"key":"e_1_3_4_37_2","doi-asserted-by":"publisher","DOI":"10.1210\/er.2010-0013"},{"key":"e_1_3_4_38_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2003-031327"},{"key":"e_1_3_4_39_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpendo.00563.2004"},{"key":"e_1_3_4_40_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.3.321"},{"key":"e_1_3_4_41_2","doi-asserted-by":"publisher","DOI":"10.1111\/obr.12270"},{"key":"e_1_3_4_42_2","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0b013e3181fb512d"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.116.004545","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T10:54:28Z","timestamp":1715597668000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.116.004545"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,2,2]]},"references-count":41,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2017,2,2]]}},"alternative-id":["10.1161\/JAHA.116.004545"],"URL":"https:\/\/doi.org\/10.1161\/jaha.116.004545","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,2,2]]},"assertion":[{"value":"2016-08-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-12-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-01-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e004545"}}