Document Detail

Predictive value of inflammatory and hemostatic parameters, atherosclerotic risk factors, and chest x-ray for aortic arch atheromatosis.
MedLine Citation:
PMID:  14657455     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: Aortic arch atheromatosis (AAA) is a common cause of cerebral embolism. Transesophageal echocardiography (TEE) shows not only the extension of atherosclerotic plaques but also the mobility of superimposed thrombi. In most cases AAA is only detected after the embolic event. This study was therefore designed to identify predictive factors for AAA. METHODS: One hundred seven consecutive patients referred for routine TEE were included in the study. Patients on warfarin therapy, with a history of recent surgery, or with any signs of infectious, immunological, or malignant diseases were excluded. RESULTS: Diabetes mellitus carried the highest risk for AAA (odds ratio, 3.0), followed by hyperlipidemia (2.5) and arterial hypertension (2.3). Age >70 years was accompanied with a 1.8-fold increased risk. Patients with aortic calcifications on standard chest x-ray had a 4.6-fold higher prevalence. Severe AAA was associated with higher levels of C-reactive protein (14.6+/-14.1 versus 4.9+/-7.2 mg/L), fibrinogen (4.20+/-1.22 versus 3.45+/-1.29 mg/L), plasmin/antiplasmin complexes (728+/-297 versus 453+/-243 microg/L), and D-dimers (980+/-652 versus 444+/-349 microg/L). CONCLUSIONS: AAA is accompanied by elevation of inflammatory and hemostatic parameters. Patients with classic cardiovascular risk factors and aortic calcifications on chest x-ray have a higher prevalence. Further prospective studies are now warranted to establish a risk score to identify patients in whom TEE screening should be undertaken.
Philipp Ehlermann; Wladimir Mirau; Jürgen Jahn; Andrew Remppis; Abdolhamid Sheikhzadeh
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Publication Detail:
Type:  Journal Article     Date:  2003-12-04
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  35     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2003-12-30     Completed Date:  2004-01-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  34-9     Citation Subset:  IM    
Medizinische Klinik, Abt Innere Medizin III- Kardiologie, Universität Heidelberg, Heidelberg, Germany.
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MeSH Terms
Age Factors
Aged, 80 and over
Aorta, Thoracic / radiography*,  ultrasonography
Arteriosclerosis / epidemiology*,  radiography*,  ultrasonography
Biological Markers / analysis
C-Reactive Protein / analysis
Calcinosis / epidemiology,  radiography
Diabetes Mellitus / epidemiology
Echocardiography, Transesophageal
Germany / epidemiology
Hyperlipidemias / epidemiology
Hypertension / embryology
Middle Aged
Odds Ratio
Predictive Value of Tests
Risk Assessment
Risk Factors
Reg. No./Substance:
0/Biological Markers; 9007-41-4/C-Reactive Protein

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