Document Detail


Atherosclerotic disease of the proximal aorta and the risk of vascular events in a population-based cohort: the Aortic Plaques and Risk of Ischemic Stroke (APRIS) study.
MedLine Citation:
PMID:  19498195     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Proximal aortic plaques are a risk factor for vascular embolic events. However, this association in the general population is unclear. We sought to assess whether proximal aortic plaques are associated with vascular events in a community-based cohort.
METHODS: Stroke-free subjects from the Aortic Plaques and Risk of Ischemic Stroke (APRIS) study were evaluated. Aortic arch and proximal descending aortic plaques were assessed by transesophageal echocardiography (TEE). Vascular events (myocardial infarction, ischemic stroke, vascular death) were prospectively recorded, and their association with aortic plaques was assessed.
RESULTS: 209 subjects were studied (age 67.0+/-8.6 years). Aortic arch plaques were present in 130 subjects (62.2%), large plaques (>or=4 mm) in 50 (23.9%). Descending aortic plaques were present in 126 subjects (60.9%), large plaques in 41 (19.8%). During a follow-up of 74.4+/-26.3 months, 29 events occurred (12 myocardial infarctions, 11 ischemic strokes, 6 vascular deaths). After adjustment for risk factors, large aortic arch plaques were not associated with combined vascular events (hazard ratio [HR] 1.03, 95% confidence intervals [CI] 0.35 to 3.02) or ischemic stroke (HR 0.59, 95% CI 0.10 to 3.39). Large descending aortic plaques were also not independently associated with vascular events (HR 1.99, 95% CI 0.52 to 7.69) or ischemic stroke (HR 1.43, 95% CI 0.27 to 7.48).
CONCLUSIONS: In a population-based cohort, the incidental detection of plaques in the aortic arch or proximal descending aorta was not associated with future vascular events. Associated cofactors may affect the previously reported association between proximal aortic plaques and vascular events.
Authors:
Cesare Russo; Zhezhen Jin; Tatjana Rundek; Shunichi Homma; Ralph L Sacco; Marco R Di Tullio
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2009-06-04
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  40     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-30     Completed Date:  2009-07-27     Revised Date:  2014-09-20    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2313-8     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Aorta, Thoracic / ultrasonography
Aortic Diseases / complications*,  mortality,  ultrasonography
Atherosclerosis / complications*,  mortality,  ultrasonography
Cohort Studies
Echocardiography, Transesophageal
Female
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Myocardial Infarction / epidemiology*
Prospective Studies
Risk Factors
Stroke / epidemiology*
Vascular Diseases / epidemiology*
Grant Support
ID/Acronym/Agency:
R01 NS036286/NS/NINDS NIH HHS; R01 NS036286-03/NS/NINDS NIH HHS; R01 NS036286-04/NS/NINDS NIH HHS; R01 NS036286-05/NS/NINDS NIH HHS; R01 NS36286/NS/NINDS NIH HHS
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