Abstract W P371: Periodontal Disease is Associated with Aortic Arch Atheroma a Marker of Recurrent Vascular Events in Stroke/TIA Patients
Background: Periodontal disease (PD) is independently associated with recurrent vascular events in Stroke/TIA. Aortic arch atheroma (AA) is an independent risk factor for stroke. The association between PD and AA has not been described.
Objective: To test the association between: 1) significant AA and recurrent vascular event in stroke/TIA 2) PD and AA (plaque severity and characteristics)
Methods: In this prospective longitudinal hospital-based cohort study, PD was assessed in Stroke/TIA patients. Based on clinical measures patients were classified to have high (HPD) versus low periodontal disease (LPD). As part of their stroke work-up, AA was assessed using transesophageal echocardiogram (TEE). Based on plaque thickness the AA was graded as mild (0-0.99 mm), moderate (1-3.99 mm) or severe (≥4 mm), as well as plaque characteristics, namely mobility, ulceration and calcification. The patients were followed up for recurrent vascular events, namely stroke, TIA, myocardial infarction and vascular death.
Results: In an eighteen-month period, 106 patients were evaluated, 40(38%) showed HPD and 27 (26%) had recurrent vascular events over a median of 24 months (range 12-24 months). AA assessed by TEE revealed 16 with mild, 73 with moderate, and 17 with severe plaque. Those with severe AA had a higher rate of recurrent vascular event compared to those without (Figure). Severe AA was associated with recurrent vascular events (HR 2.3, 95% CI, 1.02-5.32). HPD patients had higher (p = 0.004) AA plaque thickness (Mean±SD 2.0±2.4 mm) compared with LPD (1.6±1.2 mm). HPD was associated with moderate AA (OR 10.5, 95% CI, 1.3-84) and severe AA (OR 16.9, 95% CI, 1.8-158). Among plaque characteristics HPD was associated (p=0.02) with calcification.
Conclusion: In stroke/TIA patients severe AA is associated with recurrent vascular events. HPD is associated with an increased AA plaque thickness and calcification. The results suggest that PD may be a risk factor for AA.
Author Disclosures: M. Chung: None. A. Hinderliter: None. S. Offenbacher: None. J. Beck: None. S. Sen: None.
This research has received full or partial funding support from the American Heart Association, Mid-Atlantic Affiliate - District of Columbia, Maryland, North Carolina, South Carolina, Virginia.
- © 2015 by American Heart Association, Inc.