Mancio J, Barros AS, Conceicao G, et al. - Since no inquiry has been undertaken to define the role of epicardial adipose tissue (EAT) in the pathophysiology of late stage-coronary artery disease (CAD), researchers examined the link of EAT volume and its proteome with advanced coronary atherosclerosis. Prospective enrollment of 574 severe aortic stenosis patients who were referred to cardiac surgery was done in the EPICHEART Study. Computed tomography was performed prior to surgery in order to quantify EAT volume. During the operation, they obtained epicardial, mediastinal and subcutaneous adipose tissue samples to determine fat phenotype by examining the proteomic profile employing SWATH-mass spectrometry; they also obtained pericardial fluid and peripheral venous blood. Findings revealed the link of coronary calcium score with EAT volume and annexin-A2/fetuin-A signaling in an elderly cohort of stable patients. This is indicative of the possible orchestration of pro-calcifying conditions in the late phases of CAD by EAT.