Incremental diagnostic value of epicardial adipose tissue for the detection of functionally relevant coronary artery disease

•This study examined the incremental diagnostic value of epciardial adipose tissue for the detection of myocardial ischemia.•Patients underwent invasive coronary angiography in conjunction with invasive fractional flow reserve measurements.•Epicardial fat volume was only poorly correlated with coronary calcifications as indicated by the coronary calcium score.•Epicardial fat volume and the coronary calcium score have no incremental value for the detection of lesion-specific ischemia.