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Epicardial Fat Thickness and Free Fatty Acid Level are Predictors of Acute Ischemic Stroke with Atrial Fibrillation
Kyoung Im Cho1, Bong-Joon Kim1, Sang-Hoon Cho2, Meyung-Kug Kim3, Jin-Hyung Lee3, Bong-Goo Yoo3*
1Department of Cardiology, Kosin University College of Medicine
2Department of Statistics and Actuarial Science, Soongsil University
3Department of Neurology, Kosin University College of Medicine
Corresponding Author: Bong-Goo Yoo ,Tel: 051-990-6105, Email: ybg99@naver.com
ABSTRACT
Background:
Increased epicardial fat is known to be associated with the presence and chronicity of atrial fibrillation (AF). Free fatty acids (FFAs) are major components of epicardial fat; however, their potential association with AF in ischemic stroke has not been investigated. We aimed to assess the performance of echocardiographic epicardial fat thickness (EFT) and plasma FFA level in identifying patients with ischemic stroke and AF.
Methods:
We enrolled a total of 214 consecutive patients (mean age, 66.8 ± 12.3 years; 39.7% women) diagnosed with acute ischemic stroke between March 2011 and June 2014. The patients were divided into two groups: ischemic stroke with AF (n = 35, 16.4%) and ischemic stroke without AF (n = 179, 83.6%).
Results:
The ischemic stroke with AF group showed significantly higher serum FFA level (1379.7±717.5 vs. 757.8±520.5 uEq/L, p <0.0001) and EFT (6.5±1.2 vs. 5.3±1.2 mm, p<0.001) than the group without AF. Multivariable logistic regression analysis demonstrated that age (odds ratio [OR], 1.112), serum FFA level (OR, 1.002), and EFT (OR, 1.740) were independently associated with the ischemic stroke group with AF. EFT and FFA significantly improved the goodness-of-fit and discriminability of the simple regression model including age as a covariate (log likelihood difference, 21.35; p< 0.001; c-index difference, 17.9%; p< 0.001). Conclusions: High EFT and serum FFA level were associated with ischemic stroke in patients with AF. Echocardiographic EFT and serum FFA level can play a significant role in identifying ischemic stroke with AF.
Keywords: Stroke, Epicardial fat thickness, Free fatty acids, Atrial fibrillation
Volume 26, No 1
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