Korelasi Parameter Kuantitatif Epicardial Adipose Tissue dan Coronary Artery Calcium Score pada Cardiac CT dengan Derajat Stenosis Arteri Koroner

Galuh Kartika Dewi, Prof. Dr. dr. Lina Choridah, Sp.Rad., Subsp.PRP (K).; dr. Hesti Gunarti, Sp.Rad., Subsp. RA (K)

2026 | Tesis | S2 Kedokteran Klinik

Latar Belakang: Coronary artery disease (CAD) merupakan penyebab utama morbiditas dan mortalitas kardiovaskular. Selain faktor risiko klasik, epicardial adipose tissue (EAT) berperan dalam proses aterosklerosis melalui mekanisme parakrin dan inflamasi lokal. Parameter EAT serta coronary artery calcium score (CACS) dapat diukur secara noninvasif menggunakan cardiac computed tomography (CT), namun hubungannya dengan derajat stenosis arteri koroner masih menunjukkan hasil yang bervariasi.

Material dan Metode: Penelitian ini merupakan studi observasional analitik dengan desain cross-sectional retrospektif. Subjek adalah pasien dengan kecurigaan CAD yang menjalani cardiac CT. Volume dan densitas EAT serta CACS diukur menggunakan perangkat lunak semiautomatis, sedangkan derajat stenosis dinilai berdasarkan klasifikasi CAD-RADS 2.0. Analisis korelasi dilakukan menggunakan uji Spearman.

Hasil: CACS menunjukkan korelasi positif kuat dan bermakna dengan derajat stenosis arteri koroner (r = 0,734; p < 0 xss=removed xss=removed r =?0,027; xss=removed>

Kesimpulan: CACS merupakan parameter paling kuat dalam memprediksi derajat stenosis arteri koroner. Parameter EAT tidak berhubungan secara independen dengan derajat stenosis setelah dilakukan penyesuaian, yang menunjukkan bahwa EAT lebih mencerminkan aspek biologis dan inflamasi aterosklerosis dibandingkan penyempitan lumen anatomis.

Background: Coronary artery disease (CAD) is a leading cause of cardiovascular morbidity and mortality. Beyond traditional risk factors, epicardial adipose tissue (EAT) plays a role in atherosclerosis through local paracrine and inflammatory mechanisms. EAT parameters and coronary artery calcium score (CACS) can be assessed noninvasively using cardiac computed tomography (CT); however, their associations with the severity of coronary artery stenosis remain variable.

Methods: This study was an observational analytic study with a retrospective cross- sectional design. The study population consisted of patients with suspected CAD who underwent cardiac CT. EAT volume, EAT attenuation, and CACS were measured using semi-automated software, while coronary stenosis severity was assessed according to the CAD-RADS 2.0 classification. Correlation analysis was performed using Spearman’s test.

Results: CACS showed a strong and significant positive correlation with coronary artery stenosis severity (r = 0.734; p < 0 xss=removed xss=removed xss=removed p =0.756).>

Conclusion: CACS is the strongest parameter for predicting the severity of coronary artery stenosis. EAT parameters were not independently associated with stenosis severity after adjustment, suggesting that EAT more accurately reflects the biological and inflammatory aspects of atherosclerosis rather than anatomical luminal narrowing.

Kata Kunci : Epicardial adipose tissue, densitas, volume, stenosis koroner, coronary artery calcium score