Carotid intima-media thickness, epicardial/pericardial fat, and non-traditional biomarkers in acute coronary syndrome: a case-control study

Gishto, T. and Rruci, E. and Shuka, N. and Methoxha, S. and Vyshka, G. (2026) Carotid intima-media thickness, epicardial/pericardial fat, and non-traditional biomarkers in acute coronary syndrome: a case-control study. Медичні перспективи = Medicni perspektivi (Medical perspectives), Т. 31 (2). pp. 63-72. ISSN 2307-0404 (print), 2786-4804 (online)

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Abstract

Carotid intima-media thickness, epicardial/pericardial fat, and non-traditional biomarkers in acute coronary syndrome: a case-control study. Gishto T., Rruci E., Shuka N., Methoxha S., Vyshka G. Acute coronary syndrome (ACS) can occur even when the burden of traditional cardiovascular risk factors is limited, highlighting residual risk and the potential value of non-traditional markers. The purpose of this study was to assess carotid intimamedia thickness and echocardiographic epicardial/paracardial adipose tissue thickness, together with selected biomarkers, in acute coronary syndrome compared with coronary angiography or coronary computed tomographynegative controls. Carotid intima-media thickness (CIMT) and epicardial adipose tissue (EAT) capture structural and metabolic alterations that may cluster with systemic inflammatory and metabolic markers in patients with acute coronary syndrome.In this hospital-based case–control study, we enrolled 150 patients with ACS and 150 control subjects in whom obstructive coronary artery disease was ruled out by invasive coronary angiography or coronary CT angiography. Demographic and clinical data, carotid ultrasound for CIMT, transthoracic echocardiography for EAT and pericardial adipose tissue (PAT), and biochemical markers (C-reactive protein, fibrinogen, white blood cell and neutrophil counts, serum uric acid) were collected. Group comparisons, correlation analyses and receiver operating characteristic (ROC) curves were used to assess associations and discriminative performance. Compared with controls, ACS patients had significantly higher mean CIMT (1.02 vs 0.65 mm), thicker EAT (6.5 vs 3.7 mm) and PAT (5.8 vs 3.1 mm) and higher levels of all non-traditional biochemical markers (all p<0.001). CIMT, EAT and PAT correlated positively with fibrinogen, C-reactive protein, leukocyte and neutrophil counts, serum uric acid and body mass index, with positive correlations observed in both groups. CIMT demonstrated excellent discrimination for ACS (area under the curve [AUC] >0.90; sensitivity >93%; specificity >85%), with an optimal cut-off around 0.72 mm. EAT and PAT also showed strong discrimination (AUC 0.902 and 0.875, respectively), while serum uric acid achieved an AUC of 0.860 with high specificity.Patients with ACS exhibit a distinct non-traditional risk profile characterised by increased CIMT, epicardial/pericardial fat and heightened inflammatory–metabolic activation. CIMT and EAT are structural expressions of this adverse milieu and, when combined with selected non-traditional biochemical markers, demonstrate strong discrimination in this cohort. Prospective studies are needed to validate structural-inflammatory phenotypes and define their role in personalised risk stratification and prevention

Item Type:	Article
Additional Information:	doi: 10.26641/2307-0404.2026.2.365598
Uncontrolled Keywords:	Key words: acute coronary syndrome, carotid intima-media thickness, epicardial adipose tissue, uric acid; гострий коронарний синдром, товщина комплексу інтима-медіа сонних артерій, епікардіальна жирова тканина, сечова кислота
Subjects:	Cardiology
Divisions:	University periodicals > Medical perspectives
Depositing User:	Ирина Медведева
Date Deposited:	08 Sep 2026 08:20
Last Modified:	08 Sep 2026 08:20
URI:	http://repo.dma.dp.ua/id/eprint/10268

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