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Thoracic aortic atheroma severity predicts high-risk coronary anatomy in patients undergoing transesophageal echocardiography.
MedLine Citation:
PMID:  22291734     Owner:  NLM     Status:  PubMed-not-MEDLINE    
INTRODUCTION: We hypothesized a relationship between severity of thoracic aortic atheroma (AA) and prevalence of high-risk coronary anatomy (HRCA).
MATERIAL AND METHODS: We investigated AA diagnosed by transesophageal echocardiography and HRCA diagnosed by coronary angiography in 187 patients. HRCA was defined as ≥ 50% stenosis of the left main coronary artery or significant 3-vessel coronary artery disease (≥ 70% narrowing).
RESULTS: HRCA was present in 45 of 187 patients (24%). AA severity was grade I in 55 patients (29%), grade II in 71 patients (38%), grade III in 52 patients (28%), grade IV in 5 patients (3%), and grade V in 4 patients (2%). The area under receiver operating characteristic curve for AA grade predicting HRCA was 0.83 (p = 0.0001). The cut-off points of AA to predict HRCA was > II grade. The sensitivity and specificity of AA > grade II to predict HRCA were 76% and 81%, respectively. After adjustment for 10 variables with significant differences by univariate regression, AA > grade II was related to HRCA by multivariate regression (odds ratio = 7.5, p< 0.0001). During 41-month follow-up, 15 of 61 patients (25%) with AA >grade II and 10 of 126 patients (8%) with AA grade ≤ 2 died (p= 0.004). Survival by Kaplan-Meier plot in patients with AA > grade II was significantly decreased compared to patients with AA ≤ grade II (p= 0.002).
CONCLUSIONS: AA > grade II is associated with a 7.5 times increase in HRCA and with a significant reduction in all-cause mortality.
Xuedong Shen; Wilbert S Aronow; Chandra K Nair; Hema Korlakunta; Mark J Holmberg; Fenwei Wang; Stephanie Maciejewski; Dennis J Esterbrooks
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Publication Detail:
Type:  Journal Article     Date:  2011-03-08
Journal Detail:
Title:  Archives of medical science : AMS     Volume:  7     ISSN:  1896-9151     ISO Abbreviation:  Arch Med Sci     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2012-01-31     Completed Date:  2012-10-02     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101258257     Medline TA:  Arch Med Sci     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  61-6     Citation Subset:  -    
Cardiac Center of Creighton, University School of Medicine, Omaha, Nebraska, USA.
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