| Aortic arch atheroma progression and recurrent vascular events in patients with stroke or transient ischemic attack. | |
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MedLine Citation:
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PMID: 17684150 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: It is not known whether progression of aortic arch (AA) atheroma is associated with vascular events in patients with stroke or transient ischemic attack (TIA). METHODS AND RESULTS: AA atheroma was detected on baseline transesophageal echocardiogram in 167 consecutive patients who had prevalent stroke or TIA. Of these, 125 consented to a follow-up transesophageal echocardiogram at 12 months. Adequate paired AA images were obtained in 117 (78 with strokes, 39 with TIAs), which allowed detailed measurements of plaques. On admission for their index stroke or TIA, patients were assessed for stroke risk factors, stroke subtypes, baseline AA plaque characteristics, and laboratory parameters. Progression of AA atheroma was observed in 33 patients (28%) on 12-month follow-up transesophageal echocardiogram. It was determined that the progression group had significantly higher adjusted homocysteine levels (P<0.0001) and neutrophil counts (P<0.0001) than the no-progression group. These patients were followed up for a median of 1.7 years from the index stroke/TIA (range 0.5 to 4.5 years) for vascular events including stroke, TIA, myocardial infarction, and death due to vascular causes. Kaplan-Meier curves showed fewer patients with AA atheroma progression remained free of the composite vascular end point (49% compared with 89% in the no-progression group; P<0.0001). AA atheroma progression was associated with composite vascular events (hazard ratio 5.8, 95% confidence interval 2.3 to 14.5, P=0.0002) after adjustment for a propensity score based on confounders. CONCLUSIONS: In this preliminary study of stroke/TIA patients with AA atheroma on transesophageal echocardiogram, AA atheroma progression was associated with recurrent vascular events. |
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Authors:
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Souvik Sen; Alan Hinderliter; Pranab K Sen; Jennifer Simmons; James Beck; Steven Offenbacher; E Magnus Ohman; Stephen M Oppenheimer |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2007-08-07 |
Journal Detail:
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Title: Circulation Volume: 116 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2007 Aug |
Date Detail:
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Created Date: 2007-08-21 Completed Date: 2007-09-11 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 928-35 Citation Subset: AIM; IM |
Affiliation:
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Department of Neurology, University of North Carolina, Chapel Hill, USA. SenS@neurology.unc.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aorta, Thoracic / pathology* Atherosclerosis / epidemiology*, pathology*, ultrasonography Disease Progression Disease-Free Survival Echocardiography, Transesophageal Female Follow-Up Studies Homocysteine / blood Humans Hypertension / epidemiology Ischemic Attack, Transient / epidemiology* Kaplan-Meiers Estimate Male Middle Aged Prevalence Recurrence Risk Factors Stroke / epidemiology* |
| Grant Support | |
ID/Acronym/Agency:
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1K23NS02117/NS/NINDS NIH HHS; RR00046/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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454-28-4/Homocysteine |
| Comments/Corrections | |
Erratum In:
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Circulation. 2007 Sep 11;116(11):e349 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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