The accumulation of epicardial adipose tissue is associated with cardiovascular death after open surgical repair for abdominal aortic aneurysms.

This study investigates the association between epicardial adipose tissue volume (EATV) and cardiovascular (CV) death in patients undergoing open surgical repair (OSR) for abdominal aortic aneurysms (AAAs). Analyzing 492 Japanese patients with preoperative computed tomography scans, the researchers found that a higher EATV index (EATV adjusted for body surface area) was significantly correlated with increased long-term CV mortality after AAA repair, independent of other fat measures such as visceral fat area (VFA) and subcutaneous fat area (SFA). Age ≥75 years and an EATV index ≥73.8 cm³/m² were identified as significant predictors of CV death. The findings suggest that quantifying EATV via routine CT imaging may serve as a novel risk stratification tool to guide personalized postoperative management in AAA patients.