Previous studies investigated the effect of pericardial fat on cardiovascular diseases. However, until now there was no systematic review and meta‐analysis investigated this association, thus we conducted this article to assess the relationship between pericardial fat and cardiovascular diseases.

We searched PubMed, The Cochrane Library, Scopus, Google Scholar and Clinicaltrials.gov to select observational studies reported the relationship between pericardial fat and cardiovascular diseases including coronary artery disease (CAD), ventricular dysfunction, heart failure (HF), atrial fibrillation (AF), major adverse cardiac events (MACE), coronary artery calcifications (CAC), arrhythmias other than atrial fibrillation, and cardiovascular events prediction scores. Meta XL 5.3 was used for data analysis.

A total of 83 articles that included 73,934 patients were included in our analysis. The results showed that pericardial fat was significantly associated with CAD (OR = 1.38; 95% CI: 1.28–1.50), ventricular dysfunction (OR = 1.53 per 1 mm³; 95% CI: 1.17–2.01), HF (OR = 1.32 per 1 mm³; 95% CI: 1.23–1.41), AF (OR = 1.16 per 1 mm³; 95% CI: 1.09–1.24), MACE (OR = 1.39 per 1 mm³; 95% CI: 1.22–1.57), and CAC (OR = 1.15 per 1 mm³; 95% CI: 1.05–1.27). On the other hand, there was no enough data about the relationship between pericardial fat with arrhythmias other than atrial fibrillation or cardiovascular risk scores.

The analysis demonstrated that the relationship between pericardial fat volume and cardiovascular diseases was significant. Since pericardial fat is a good predictor of obesity, it suggests investigating its relationship and adds on effect to previously established risk factor to evaluate the possibility of incorporating it with cardiovascular risk scores.