Abstract 3278: Aortic Arch Complicated Lesion is Strongly Associated with Recurrence of Ischemic Stroke
Background: Aortic arch plaque is a risk factor for ischemic stroke. The aim of this study was to identify whether aortic arch plaque is also a risk factor for recurrence of ischemic stroke.
Methods: We performed transesophageal echocardiography for source of emboli in 452 acute stroke patients between 2002 January and 2010 July. We investigated age, gender, incidence of atrial fibrillation, antithrombotic therapy, diabetes mellitus, hypertension, dyslipidemia, history of ischemic heart disease, history of peripheral artery disease, smoking, and transesophageal echocardiographic findings, such as spontaneous echo contrast in the left atrium, patent foramen ovale, and aortic atheroma ≥4.0 mm(complicated plaque). We compared these clinical findings between patients with the first ever stroke and those with recurrent stroke by univariate and multivariate analysis.
Results: We developed 383 patients with the first ever stroke and 69 patients who had recurrent stroke. Univariate analysis demonstrated that age(66.8±12.1 VS 71.4±9.9, p<0.05), antithrombotic therapy(21% VS 70%, p<0.05, 97 with antiplatelet, 23 with anticoagulation, 9 with both), diabetes mellitus(25% VS 41%, p<0.05), history of ischemic heart disease(9% VS 20%, p<0.05), history of peripheral artery disease(3% VS 7%, p<0.05), smoking(29% VS 14%, p<0.05) and aortic atheroma > or =4.0 mm(40% VS 61%, p<0.05) were associated with recurrence of ischemic stroke. Multivariate analysis showed that antithrombotic therapy (OR 7.55, 95%CI 4.29-13.66) and aortic atheroma > or =4.0 mm (OR 1.83, 95%CI 1.04-3.26) were independently associated with recurrence of ischemic stroke.
Conclusions: Aortic atheroma > or =4.0 mm seems to associate with reccurence of ischemic stroke regardless of antithrombotic therapy.
- © 2012 by American Heart Association, Inc.