{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T09:20:51Z","timestamp":1764753651186,"version":"3.46.0"},"reference-count":20,"publisher":"PAGEPress Publications","license":[{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Monaldi Arch Chest Dis"],"abstract":"<jats:p>The relationship between increased pericardial fat volume (PFV) and coronary plaque characteristics in patients with metabolic syndrome (MetS) is unclear. We aimed to assess PFV and coronary plaque characteristics, including type, stenosis severity, and presence of multiple plaques, among patients with MetS being evaluated for suspected coronary artery disease (CAD). This retrospective study included patients with suspected CAD who underwent computed tomography coronary angiography to exclude the presence of occlusive CAD. MetS diagnosis was based on the American Association of Clinical Endocrinologists criteria. The study included 811 individuals with suspected CAD who underwent MDCT examinations: 127 were in the MetS group, 71 were in the diabetes mellitus (DM) group, and 613 were in the control group (neither DM nor MetS). PFV was higher in the MetS group compared to the DM and the control groups (p=0.003). The MetS group had a higher prevalence of multiple (p&lt;0.001) and mixed coronary plaques (p&lt;0.001) compared to other groups. Increased age [odds ratio (OR) confidence interval (CI)=1.1(1-1.2), p=0.039] and PFV [OR (CI)=1 (1-1.2), p=0.027] showed an independent association with multiple plaque presence, while PFV was an independent predictor of mixed plaque presence [OR (CI)=1.1 (1-1.2), p=0.008]. In conclusion, patients with MetS had larger PFV and a higher prevalence of mixed and multiple coronary plaques than patients without MetS. PFV showed an independent and significant association with mixed and multiple coronary plaques among patients with MetS.<\/jats:p>","DOI":"10.4081\/monaldi.2025.3390","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T09:19:24Z","timestamp":1764753564000},"source":"Crossref","is-referenced-by-count":0,"title":["Coronary plaques and pericardial fat volume assessment in patients with metabolic syndrome being evaluated for suspected coronary artery disease"],"prefix":"10.4081","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5730-7383","authenticated-orcid":false,"given":"Abdulameer A.","family":"Al-Mosawi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0238-0460","authenticated-orcid":false,"given":"Hussein","family":"Nafakhi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4791-3653","authenticated-orcid":false,"given":"Wasan Kadhum","family":"Abbas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0337-3198","authenticated-orcid":false,"given":"Hayder","family":"Nafakhi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2549","published-online":{"date-parts":[[2025,12,3]]},"reference":[{"key":"68253","doi-asserted-by":"crossref","unstructured":"Kassi E, Pervanidou P, Kaltsas G, Chrousos G. Metabolic syndrome: definitions and controversies. BMC Med 2011;9:48.","DOI":"10.1186\/1741-7015-9-48"},{"key":"68254","doi-asserted-by":"crossref","unstructured":"Onesi SO, Ignatius UE. Metabolic syndrome: performance of five different diagnostic criterias. Indian J Endocrinol Metab 2014;18:496-501.","DOI":"10.4103\/2230-8210.137494"},{"key":"68255","doi-asserted-by":"crossref","unstructured":"Tarsitano MG, Pandozzi C, Muscogiuri G, et al. Epicardial adipose tissue: a novel potential imaging marker of comorbidities caused by chronic inflammation. Nutrients 2022;14:2926.","DOI":"10.3390\/nu14142926"},{"key":"68256","doi-asserted-by":"crossref","unstructured":"Yonetsu T, Kato K, Uemura S, et al. Features of coronary plaque in patients with metabolic syndrome and diabetes mellitus assessed by 3-vessel optical coherence tomography. 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J Diabetes Metab Disord 2023;22:713-9.","DOI":"10.1007\/s40200-023-01190-9"},{"key":"68260","doi-asserted-by":"crossref","unstructured":"Packer M. Epicardial adipose tissue may mediate deleterious effects of obesity and inflammation on the myocardium. J Am Coll Cardiol 2018;71:2360-72.","DOI":"10.1016\/j.jacc.2018.03.509"},{"key":"68261","doi-asserted-by":"crossref","unstructured":"Konwerski M, G\u0105secka A, Opolski G, et al. Role of epicardial adipose tissue in cardiovascular diseases: a review. Biology 2022;11:355.","DOI":"10.3390\/biology11030355"},{"key":"68262","doi-asserted-by":"crossref","unstructured":"Ma ZY, Duan H, Han D, et al. Epicardial fat in patients with metabolic syndrome: A systematic review and meta-analysis. Eur J Radiol 2023;167:111056.","DOI":"10.1016\/j.ejrad.2023.111056"},{"key":"68263","doi-asserted-by":"crossref","unstructured":"Echevarria-Castro N, Silva-Parra K, Polar-Trinidad M, et al. Concordance between different criteria for metabolic syndrome in peruvian adults undergoing bariatric surgery. J Clin Med 2022;11:4692.","DOI":"10.3390\/jcm11164692"},{"key":"68264","doi-asserted-by":"crossref","unstructured":"Cury MV, Presti C, Bonadiman SS, et al. Carotid plaque morphology in asymptomatic patients with and without metabolic syndrome. Ann Vasc Surg 2017;39:173-81.","DOI":"10.1016\/j.avsg.2016.05.092"},{"key":"68265","doi-asserted-by":"crossref","unstructured":"Marso SP, Mercado N, Maehara A, et al. Plaque composition and clinical outcomes in acute coronary syndrome patients with metabolic syndrome or diabetes. JACC Cardiovasc Imaging 2012;5:S42-52.","DOI":"10.1016\/j.jcmg.2012.01.008"},{"key":"68266","doi-asserted-by":"crossref","unstructured":"Lim S, Shin H, Lee Y, et al. Effect of metabolic syndrome on coronary artery stenosis and plaque characteristics as assessed with 64-detector row cardiac CT. Radiology 2011;261:437-45.","DOI":"10.1148\/radiol.11101725"},{"key":"68267","doi-asserted-by":"crossref","unstructured":"Kim LK, Yoon JW, Lee DH, et al. Impact of metabolic syndrome on the progression of coronary calcium and of coronary artery disease assessed by repeated cardiac computed tomography scans. Cardiovasc Diabetol 2016;15:92.","DOI":"10.1186\/s12933-016-0404-7"},{"key":"68268","doi-asserted-by":"crossref","unstructured":"Park GM, An H, Lee SW, et al. Impact of metabolic syndrome on subclinical atherosclerosis in asymptomatic individuals. Circ J 2015;79:1799-806.","DOI":"10.1253\/circj.CJ-14-1197"},{"key":"68269","doi-asserted-by":"crossref","unstructured":"Villasante Fricke AC, Iacobellis G. Epicardial adipose tissue: clinical biomarker of cardio-metabolic risk. Int J Mol Sci 2019;20:5989.","DOI":"10.3390\/ijms20235989"},{"key":"68270","doi-asserted-by":"crossref","unstructured":"Yamashita K, Yamamoto MH, Igawa W, et al. Association of epicardial adipose tissue volume and total coronary plaque burden in patients with coronary artery disease. Int Heart J 2018;59:1219-26.","DOI":"10.1536\/ihj.17-709"},{"key":"68271","doi-asserted-by":"crossref","unstructured":"Iacobellis G. Epicardial adipose tissue in contemporary cardiology. Nat Rev Cardiol 2022;19:593-606.","DOI":"10.1038\/s41569-022-00679-9"},{"key":"68272","doi-asserted-by":"crossref","unstructured":"Li C, Liu X, Adhikari BK, et al. The role of epicardial adipose tissue dysfunction in cardiovascular diseases: an overview of pathophysiology, evaluation, and management. 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