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(Stroke. 1997;28:36-39.)
© 1997 American Heart Association, Inc.
Articles |
Vascular Events During Follow-up in Patients With Aortic Arch Atherosclerosis
the Medical Department of Cardiology, University of Lubeck (R.M., H.W., C.M., C.T., U.S., A.S.), and the Department of Neurology (C.D., C.K.), University of Greifswald (Germany).
Correspondence to Dr Rolf Mitusch, Department of Cardiology, Medical University of Lubeck, D-23538 Lubeck, Germany.
Background and Purpose An association between aortic arch atherosclerosis and vascular events has been demonstrated. However, few data exist regarding follow-up evaluation of this disease.
Methods In this study, 183 patients with the diagnosis of aortic arch atherosclerosis were prospectively followed up. This diagnosis was made during an echocardiographic cross-sectional study. In 136 patients, raised plaques with thickness <5 mm had been shown to exist, and in 47 patients complex plaques with thickness 
5 mm or plaques with mobile components had been demonstrated on the initial transesophageal echocardiography.
Results During a mean follow-up period of 16±7 months, vascular events with a presumed embolic origin occurred in 15 patients. The incidence was 4.1 per 100 person-years in patients with raised plaques compared with 13.7 per 100 person-years in the group with complex plaques. The Kaplan-Meier survival analysis revealed a significantly higher rate of vascular events in patients who were found to have complex plaques (P<.01). In the Cox proportional hazards analysis, the finding of complex plaques (relative risk [RR], 4.3; 95% confidence interval [CI], 1.5 to 12.0; P=.006), coronary artery disease (RR, 4.0; 95% CI, 1.2 to 13.1; P=.02), and a history of previous embolism (RR, 4.0; 95% CI, 1.1 to 14.4; P=.03) were independent predictors of vascular events.
Conclusions Patients with the finding of protruding plaques or plaques with mobile components have a high risk of subsequent vascular events.
Key Words: aortic arch • atherosclerosis • echocardiography • embolism
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