Echocardiographic Epicardial Fat Thickness and Neutrophil to Lymphocyte Ratio Are Novel Inflammatory Predictors of Cerebral Ischemic Stroke

Background: The role of epicardial fat thickness (EFT) in ischemic stroke (IS) has not been previously investigated. The aim of the present study was to evaluate EFT and neutrophil/lymphocyte ratio (NLR) among patients with IS and to examine the relationship between these inflammatory markers and the incidence of IS. Methods: The cross-sectional design includes 38 patients with IS and 47 age- and sex-matched healthy controls. Echocardiographic measurement of EFT was conducted according to previously published methods. An automated hematology analyzer was used to generate total and differential leukocyte counts from patient blood samples. Results: Mean EFT was 4.86 +/- .68 mm in the control group and 5.95 +/- 1.14 mm in the IS group. EFTwas significantly greater in the IS patients in relation to the control group (P < .001). Mean NLR was significantly greater among IS patients in relation to the control group (2.5 +/- .6 vs. 1.8 +/- .4, P < .001). No significant confounding factors were identified in the data set. Spearman's correlation analysis revealed a mild, but highly significant correlation between EFT and NLR (r = 5.293, P =.006). Conclusions: This study demonstrates for the first time the association between EFT and cerebral IS. Echocardiographic EFT was significantly correlated with NLR. NLR and echocardiographic EFT represent inexpensive and readily available clinical markers that maybe useful in estimating risk of IS.