Complex Aortic Arch Atherosclerosis in Acute Ischemic Stroke Patients with Non-Valvular Atrial Fibrillation

Autor: Reiji Koide, Takafumi Mashiko, Kumiko Miura, Masayuki Suzuki, Kohei Furuya, Ryota Tanaka, Shigeru Fujimoto, Misato Ozawa, Kosuke Matsuzono, Tadashi Ozawa
Rok vydání: 2020
Předmět:
Male
Aortic arch
medicine.medical_specialty
Aortic Diseases
Aorta
Thoracic
030204 cardiovascular system & hematology
Non-valvular atrial fibrillation
Risk Assessment
Complex aortic arch plaque
03 medical and health sciences
Diabetes mellitus
0302 clinical medicine
Japan
Risk Factors
Internal medicine
medicine.artery
Atrial Fibrillation
Prevalence
Internal Medicine
medicine
Humans
Acute stroke
Aged
Ischemic Stroke
Retrospective Studies
Aged
80 and over
business.industry
Biochemistry (medical)
Age Factors
Atrial fibrillation
Odds ratio
medicine.disease
Plaque
Atherosclerotic
Confidence interval
Low HDL-C
Stenosis
Intracranial Embolism
Concomitant
Cardiology
Female
Original Article
Cardiology and Cardiovascular Medicine
business
Echocardiography
Transesophageal
030217 neurology & neurosurgery
Kidney disease
Zdroj: Journal of Atherosclerosis and Thrombosis
ISSN: 1880-3873
1340-3478
Popis: Aim: Aortic arch atherosclerosis, particularly complex aortic arch plaques (CAPs), is an important source of cerebral emboli. CAPs and atrial fibrillation (AF) often co-exist; however, the prevalence and risk of CAPs in acute ischemic stroke patients with AF is unclear. Methods: In patients with acute ischemic stroke with non-valvular AF admitted to Jichi Medical University Hospital during April 2016 to September 2019, we retrospectively evaluated the presence of CAPs on transesophageal echocardiography (TEE). Results: CAPs were observed in 41 (38.7 %) of 106 patients with non-valvular AF. Older age, diabetes mellitus, chronic kidney disease, low high-density lipoprotein cholesterol (HDL-C) levels, higher levels of glycohemoglobin A1c (HbA1c), higher CHADS 2 and CHA 2 DS 2 -VASc scores, and intracranial or carotid artery stenosis were more frequently observed in CAPs-positive than in CAPs-negative patients. In multivariable analyses, older age (odds ratio [OR]: 1.2 per year increase; 95% confidence interval [CI]: 1.07–1.24; P ＜0.0001), diabetes mellitus (OR: 4.7; 95%CI: 1.27-17.35; P ＜0.05), and low HDL-C (OR: 0.95 per 1 mg/dl increase; 95%CI: 0.92-0.99; P ＜0.01) were independent risk factors for CAPs. The prevalence of CAPs was age-dependent, and there was a significantly higher risk in patients aged either 75–84 years or ＞84 years than in those aged ＜65 (OR: 7.6; 95%CI: 1.50-38.62, and OR: 32.1; 95%CI: 5.14-200.11, respectively). Conclusions: Even in patients with ischemic stroke with non-valvular AF, concomitant CAPs should be considered in older individuals and those who have diabetes or low HDL-C.
Databáze: OpenAIRE
Externí odkaz: