Relationship of pericardial fat with biomarkers of inflammation and hemostasis, and cardiovascular disease: the Multi-Ethnic Study of Atherosclerosis

OBJECTIVE: Pericardial fat may increase the risk of cardiovascular disease (CVD) by increasing circulating levels of inflammation and haemostasis biomarkers. We investigated the associations of pericardial fat with inflammation and haemostasis biomarkers, as well as incident CVD events, and whether there are any ethnic differences in these associations. METHODS: We analysed results from 6415 participants from the Multi-Ethnic Study of Atherosclerosis who had measurements of pericardial fat volume and circulating levels of C-reactive protein, fibrinogen, interleukin (IL)– 6, factor VIII, D-dimer and plasmin-antiplasmin complex (PAP), and had a mean follow-up period of 9.5 years. Incident CVD event was defined as any adjudicated CVD event. RESULTS: After adjusting for confounding factors, pericardial fat volume was positively associated with natural log (ln) of IL-6 levels, but inversely associated with ln D-dimer and ln PAP levels (β=0.067, -0.032, and -0.105 respectively, all P < 0.05). Although a larger pericardial fat volume was associated with a higher risk of incident CVD, the association was attenuated to borderline significance after adjusting for traditional cardiovascular risk factors (P=0.050). There was a borderline significant ethnicity interaction (P=0.080), whereby the association between pericardial fat volume and incident CVD was significant in Hispanic Americans, even after further adjusting for biomarkers of inflammation and haemostasis (hazard ratio=1.31 per standard deviation increase; 95% confidence interval, 1.09-1.57; P=0.004). CONCLUSION: Pericardial fat was associated with several inflammation and haemostasis biomarkers. The association of pericardial fat with incident CVD events was independent of these biomarkers only among Hispanic Americans