Abstract W P145: Increased Areas of Pericardial and Intrathoracic Adipose Tissue Predict Early Mortality or Recurrent Stroke and Reflect Systemic Inflammation in Patients With Ischemic Stroke

Abstract

Introduction: Chronic low-grade inflammation is a recognized risk factor for all cardiovascular diseases (CVD). Of different kind of adipose tissue located in the thoracic cavity the pericardial (PAT) but not intrathoracic adipose tissue (IAT) has been shown to associate with the risk of CVD. Hypothesis: We assessed the hypothesis that increased areas of both PAT and IAT are associated with systemic inflammation, early mortality, and recurrent stroke. Methods: A total of 162 patients (69 % men, mean age 61 years) with embolic stroke of undetermined or suspected cardiogenic etiology were studied. Areas of PAT and IAT were assessed by cardiac CT performed at the time of hospital admission. Plasma levels of Interleukin (IL-) 6, IL-1, IL-10, IL-18, tumor necrosis factor (TNF) and high sensitivity CRP were assessed three months after stroke. Follow-up data of mortality and recurrent stroke was collected up to five years after the first stroke. Results: Patients who encountered death (n=18) or recurrent stroke (n=25) during the follow-up time had larger PAT (14.5 cm2 vs 11.9 cm2, p=0.041) and IAT (30.9 cm2 vs 26.1 cm2, p=0.038) areas, and also had higher plasma levels of IL-6 (p=0.047). PAT and IAT areas were associated with plasma levels of IL-6 (r=0.251; p=0.042 and r=0.287; p=0.019, respectively). Conclusions: Patients who encountered either death or recurrent stroke during the five-year follow-up period had larger areas of PAT and IAT and higher plasma levels of IL-6 suggesting that both PAT and IAT, and contiguous systemic low-grade inflammation may have a role in the pathogenesis of embolic stroke of undetermined or cardiogenic origin.