The presence and amount of fat around the heart could be an independent risk marker for coronary artery disease.

Researchers at Korea University Guro Hospital in Seoul first established a correlation between pericardial adipose tissue and coronary atherosclerosis. Their cardiac CT angiography study of 165 chest pain patients with normal body mass showed those who developed coronary artery plaque had a significantly larger area of pericardial fat compared with those with normal scans. Researchers at the Medical University of South Carolina made a similar discovery in a study of 129 chest pain patients who underwent CTA and conventional angiography. They found a strong correlation between signs of disease and relatively high amounts of epicardial or intrathoracic fat volumes. They released findings at the 2008 RSNA meeting.