The Study
Epicardial fat thickness predicts severe coronary artery disease and high mortality risk among ST-elevation myocardial infarction patients
This study found that people who had a heart attack and had more fat around their heart tended to have worse artery blockages and were more likely to have problems later. But it doesn't prove that the fat caused those problems—maybe other things like being overweight or eating unhealthy foods caused both.
Analysis score
Maximum 44 for a cross-sectional study.
Where the score came from
Scientists measured a layer of fat around the heart using ultrasound in people who had a serious heart attack and survived. They wanted to know if more fat meant worse heart damage.
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 544 / 100
Quality score
Snapshots of a population at a single point in time, or descriptions of small groups. Can identify correlations and prevalence, but cannot determine cause and effect.
Key takeaways
Summary
Based on the study abstract and findings.
- 1Yes — this fat layer is a simple, non-invasive sign that someone’s heart arteries are likely very damaged and they’re at much higher risk of another heart problem within half a year.
- 2People with more than 5.45 mm of heart fat had 7 times higher odds of severe artery blockages, 2 times higher risk of dying within 6 months, and nearly 2 times higher chance of having large blood clots in their arteries.
Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data
Publication
Journal
Echo Research & Practice
Year
2025
Authors
H. El-Naggar, Jacqueline G. Abdel‑Maseh, H. Hasan-Ali, Shimaa S. Khidr
Related Content
Claims (6)
People with more epicardial fat have five times the rate of coronary events compared to those with less epicardial fat.
In people who survived a specific type of heart attack, a thicker layer of fat around the heart measured by ultrasound is linked to more severe artery blockages, greater blood clot buildup, and a higher chance of serious heart problems within six months, even after accounting for body weight and other known risk factors.
In patients who survived a specific type of heart attack, those with epicardial fat thickness of 5.45 mm or greater have 7.38 times higher odds of having severe coronary artery disease, as measured by syntax score, compared to those with less fat, regardless of their body mass index.
Among people who survived a specific type of heart attack, those with epicardial fat thickness of 5.45 mm or greater have 1.8 times higher odds of having a large blood clot in their coronary arteries, compared to those with less fat, after accounting for other health factors.
In patients who survived a specific type of heart attack, the amount of fat around the heart measured by ultrasound is strongly linked to the severity of artery blockages and the predicted risk of death.
In patients who survived a specific type of heart attack, those with epicardial fat thickness of 5.45 mm or greater measured by echocardiography have a 2.36 times higher risk of dying within six months, as defined by a Grace score of 128 or higher, even after accounting for age and body mass index.
Not medical advice. For informational purposes only. Always consult a qualified healthcare professional before making health decisions.