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Elevated Epicardial Adipose Tissue and Ischemic Stroke Risk: A Systematic Review and Meta-Analysis.

Arankesh Mahadevan1, Monitha Pinnamaneni2, Manaswini Krishnakumar3

  • 1Department of Neurology, University of Utah Health, Salt Lake City, UT 84132, USA.

Medicina (Kaunas, Lithuania)
|December 31, 2025
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Summary

Increased epicardial adipose tissue (EAT) is linked to a higher risk of acute ischemic stroke (AIS), especially in patients with cardiovascular conditions like atrial fibrillation (AFib). Measuring EAT may help predict stroke risk.

Keywords:
atrial fibrillationepicardial adipose tissueischemic strokerisk stratification

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Area of Science:

  • Cardiology
  • Neurology
  • Metabolic Syndrome

Background:

  • Epicardial adipose tissue (EAT) is a visceral fat depot with pro-inflammatory properties.
  • EAT contributes to cardiovascular diseases, including atrial fibrillation (AFib) and acute ischemic stroke (AIS).
  • The association between EAT and AIS risk in patients with comorbidities requires further investigation.

Purpose of the Study:

  • To conduct a meta-analysis evaluating the association between epicardial adipose tissue (EAT) and acute ischemic stroke (AIS) risk.
  • To focus on populations with existing cardiovascular comorbidities, such as AFib.
  • To explore the role of EAT in stroke pathophysiology.

Main Methods:

  • Adherence to MOOSE and PRISMA guidelines for meta-analysis.
  • Comprehensive literature search of PubMed, SCOPUS, and Embase databases.
  • Inclusion of RCTs, cohort, case-control, and cross-sectional studies with statistical analysis using pooled odds ratios (ORs) and random-effects models.

Main Results:

  • Eight studies with 7412 participants were included.
  • Increased EAT thickness significantly correlated with higher odds of AIS (aOR: 3.60 [2.26-5.74]).
  • Higher epicardial adipose volume was also associated with increased AIS risk (aOR: 1.17 [1.03-1.34]).

Conclusions:

  • Increased EAT thickness and volume are associated with elevated AIS risk in patients with cardiovascular comorbidities.
  • EAT's inflammatory and pro-thrombotic characteristics may play a role in stroke development.
  • EAT assessment could enhance stroke risk stratification in clinical practice.