The Study
Could epicardial fat measurement play an additional role in predicting cardiovascular events based on coronary artery calcium score?
This study looked at a group of people over time and noticed that those with more fat around their heart tended to have more heart problems. But it didn’t change anything on purpose—it just watched. So we can’t say the fat caused the problems, just that they often happened together.
Analysis score
Maximum 72 for a cohort study.
Where the score came from
Scientists measured fat around the heart and calcium in heart arteries to see who might have a heart problem later.
Where does this study sit?
Reviews of RCTs (Meta-analyses)
Max 100Randomized Trials
Max 90Reviews of Cohort Studies
Max 85Cohort Studies
Max 72Reviews of Case-Control Studies
Max 63Case-Control Studies
Max 58Cross-Sectional & Case Series
Max 50Expert Opinion
Max 552 / 100
Quality score
Groups of people are followed over time to see who develops an outcome. Strong for identifying risk factors and associations, but cannot prove causation as firmly as RCTs.
Key takeaways
Summary
Based on the study abstract and findings.
- 1Yes — having both high heart fat and high artery calcium makes a person over five times more likely to have a heart event than someone with low levels of both.
- 2Of 1,024 people, 41 had heart events.
- 3Those with high fat and high calcium had 5.5 times higher risk; those with low fat and low calcium were most likely to stay healthy.
Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data
Publication
Journal
European Heart Journal
Year
2025
Authors
D. Sa, M. Mendonca, F. Sousa, G. Abreu, M. Ferreira, J. Sousa, M. Serrão, E. Henriques, M. Rodrigues, S. Freitas, S. Borges, I. Ornelas, A. Drumond, A. Sousa, R. Palma dos Reis
Related Content
Claims (4)
People with more epicardial fat have five times the rate of coronary events compared to those with less epicardial fat.
People with more fat around the heart have a higher rate of heart attacks and other cardiovascular events, even when their coronary artery calcium levels are taken into account.
In middle-aged and older adults, measuring both epicardial fat volume and coronary artery calcium provides a more accurate prediction of future heart events than measuring coronary artery calcium alone.
Middle-aged and older adults with both low levels of fat around the heart and low calcium buildup in heart arteries had the highest survival rates over 7.3 years.
Not medical advice. For informational purposes only. Always consult a qualified healthcare professional before making health decisions.