{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T09:19:46Z","timestamp":1788254386389,"version":"build-2803163510"},"reference-count":34,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Peking Union Medical College Hospital Talent Cultivation Program Category D","award":["UHB11894"],"award-info":[{"award-number":["UHB11894"]}]},{"name":"Noncommunicable Chronic Diseases-National Science and Technology Major Project","award":["2023ZD0517200"],"award-info":[{"award-number":["2023ZD0517200"]}]},{"name":"the National High Level Hospital Clinical Research Funding","award":["2025-PUMCH-A-175"],"award-info":[{"award-number":["2025-PUMCH-A-175"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Cardiovasc. Dev. Dis.","JCDD"],"abstract":"<jats:p>Background: Epicardial adipose tissue (EAT) has been associated with coronary artery disease (CAD) in middle-aged and mixed-age populations, but its value in adults aged 80 years and older remains uncertain. This study investigated whether computed tomography (CT)-derived EAT volume provides incremental value for discriminating CAD in this very elderly population. Methods: We retrospectively included 155 patients aged \u226580 years who underwent coronary imaging evaluation between 2020 and 2022. EAT volume was quantified from non-contrast chest CT. Logistic regression, CatBoost modeling, and SHapley Additive exPlanations (SHAP) were used to assess the association of EAT with CAD, its discriminative value, and its relative contribution. Results: Forty-five patients (29.0%) had CAD. Median EAT volume did not differ between groups (p = 0.716) and was not associated with CAD after adjustment for age, sex, body mass index, diabetes, and glycated hemoglobin A1c (HbA1c). Adding EAT did not improve discrimination in logistic regression [area under the curve (AUC) 0.698 vs. 0.697; likelihood-ratio p = 0.945] or in cross-validated CatBoost analysis (AUC 0.623 vs. 0.614). SHAP ranked EAT eighth of eighteen predictors, below lipoprotein(a), total cholesterol, left atrial diameter, HbA1c, low-density lipoprotein cholesterol, diabetes, and atrial fibrillation. Conclusions: In adults aged 80 years and older, CT-derived EAT volume was not independently associated with CAD and added no discriminative value beyond conventional clinical risk factors. Total EAT volume may have limited utility as a CAD marker in very elderly adults.<\/jats:p>","DOI":"10.3390\/jcdd13090424","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T08:31:13Z","timestamp":1788251473000},"page":"424","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Epicardial Adipose Tissue Shows No Significant Incremental Value for Discriminating Coronary Artery Disease in Adults Aged 80 Years and Older: A Machine Learning Analysis"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2664-4181","authenticated-orcid":false,"given":"Jingyi","family":"Li","sequence":"first","affiliation":[{"name":"Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"}]},{"given":"Ziwei","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"}]},{"given":"Xuefeng","family":"Ni","sequence":"additional","affiliation":[{"name":"Department of Health Care, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"}]},{"given":"Hui","family":"Lian","sequence":"additional","affiliation":[{"name":"Department of Health Care, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1038\/s41569-022-00679-9","article-title":"Epicardial adipose tissue in contemporary cardiology","volume":"19","author":"Iacobellis","year":"2022","journal-title":"Nat. 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