Combined assessment of carotid intima–media thickness and epicardial fat thickness for cardiovascular risk stratification in asymptomatic South Indian adults

Background Carotid intima-media thickness (cIMT) and epicardial fat thickness (EFT) are non-invasive imaging markers associated with cardiovascular risk. This study evaluated the associations between cIMT, EFT, individual cardiovascular risk factors, cumulative cardiovascular risk-factor burden in asymptomatic adults undergoing routine cardiovascular health assessment. Methods A cross-sectional study was conducted in 925 asymptomatic adults aged ≥18 years undergoing routine cardiovascular health evaluations. Participants were classified into a control group without cardiovascular risk factors ( n  = 179) and a study group with one or more cardiovascular risk factors ( n  = 746). Carotid intima-media thickness was measured using carotid ultrasonography, and epicardial fat thickness was assessed by transthoracic echocardiography. Associations between imaging measurements, cardiovascular risk factors, cumulative cardiovascular risk-factor burden, were evaluated using descriptive and comparative statistical analyses. Results Participants with one or more cardiovascular risk factors demonstrated significantly greater right cIMT (0.681 ± 0.186 mm vs. 0.576 ± 0.144 mm, p  p  p  p  p  p  p   Conclusions Asymptomatic adults with cardiovascular risk factors demonstrated significantly greater carotid intima-media thickness and epicardial fat thickness than those without risk factors. Increasing age and cumulative cardiovascular risk-factor burden were associated with progressive increases in both imaging markers. These findings support the use of cIMT and EFT as complementary non-invasive imaging markers that may improve cardiovascular risk stratification alongside conventional risk assessment.