Epicardial Fat Thickness as a predictor of acute ischemic stroke at Rehman Medical Institute: A case-control study

Introduction: Stroke is the leading cause of disability in the globe. There are numerous markers that can be employed to predict stroke risk. Epicardial Fat Thickness (EFT) is proposed to be one of them. Objective: To determine Epicardial Fat Thickness as an independent predictor for acute ischemic stroke. Materials & Methods: This case control study included 160 subjects, 80 patients with acute ischemic stroke (AIS) and 80 healthy, gender-matched controls. AIS was diagnosed on clinical examination (Bamford classification) and National Institute of Health Stroke Scale (NIHSS) and confirmed on Brain Imaging (CT or MRI brain). Echocardiographic evaluation was done for all patients. EFT was measured using transthoracic echocardiography. To establish the association, cut off value of EFT was taken as 4mm. SPSS version 24 was used for data analysis with p<0.05 taken as level of significance. Predictive value of EFT was estimated by Receiver Operating Characteristic (ROC) curve analysis. Results: In the control group the mean age was 49.26±13.76 years with 61.2% (n=49) males. Among the cases, mean age was 61.4±12.09 years with 56.2% (n=35) males. Mean EFT (5.42±2.23) in cases was higher than control group (3.15±2.32) (p <0.0001). Taking cutoff value of 4mm, 78.8% cases had EFT>4mm while only 25% controls had value over 4mm. Logistic regression analysis revealed EFT (OR 6.381; p <0.0001) and age (OR 1.033; p=0.045) were independent predictors of AIS. ROC curve showed that cut off value of 3.75mm for EFT, predict AIS with high sensitivity (81.3%) and specificity (74.8%) with ROC area 0.819; 95% CI (0.751-0.888), P value < 0.0001. Conclusion: EFT is an independent predictor of non-cardioembolic acute ischemic stroke.