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Complex Aortic Arch Atherosclerosis in Acute Ischemic Stroke Patients with Non-Valvular Atrial Fibrillation
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 acu...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Japan Atherosclerosis Society
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8265927/ https://www.ncbi.nlm.nih.gov/pubmed/32908035 http://dx.doi.org/10.5551/jat.58339 |
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author | Suzuki, Masayuki Furuya, Kohei Ozawa, Misato Miura, Kumiko Ozawa, Tadashi Matsuzono, Kosuke Mashiko, Takafumi Koide, Reiji Fujimoto, Shigeru Tanaka, Ryota |
author_facet | Suzuki, Masayuki Furuya, Kohei Ozawa, Misato Miura, Kumiko Ozawa, Tadashi Matsuzono, Kosuke Mashiko, Takafumi Koide, Reiji Fujimoto, Shigeru Tanaka, Ryota |
author_sort | Suzuki, Masayuki |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-8265927 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Japan Atherosclerosis Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-82659272021-07-14 Complex Aortic Arch Atherosclerosis in Acute Ischemic Stroke Patients with Non-Valvular Atrial Fibrillation Suzuki, Masayuki Furuya, Kohei Ozawa, Misato Miura, Kumiko Ozawa, Tadashi Matsuzono, Kosuke Mashiko, Takafumi Koide, Reiji Fujimoto, Shigeru Tanaka, Ryota J Atheroscler Thromb Original Article 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. Japan Atherosclerosis Society 2021-07-01 2020-09-10 /pmc/articles/PMC8265927/ /pubmed/32908035 http://dx.doi.org/10.5551/jat.58339 Text en 2021 Japan Atherosclerosis Society https://creativecommons.org/licenses/by-nc-sa/3.0/This article is distributed under the terms of the latest version of CC BY-NC-SA defined by the Creative Commons Attribution License.http://creativecommons.org/licenses/by-nc-sa/3.0/ (https://creativecommons.org/licenses/by-nc-sa/3.0/) |
spellingShingle | Original Article Suzuki, Masayuki Furuya, Kohei Ozawa, Misato Miura, Kumiko Ozawa, Tadashi Matsuzono, Kosuke Mashiko, Takafumi Koide, Reiji Fujimoto, Shigeru Tanaka, Ryota Complex Aortic Arch Atherosclerosis in Acute Ischemic Stroke Patients with Non-Valvular Atrial Fibrillation |
title | Complex Aortic Arch Atherosclerosis in Acute Ischemic Stroke Patients with Non-Valvular Atrial Fibrillation |
title_full | Complex Aortic Arch Atherosclerosis in Acute Ischemic Stroke Patients with Non-Valvular Atrial Fibrillation |
title_fullStr | Complex Aortic Arch Atherosclerosis in Acute Ischemic Stroke Patients with Non-Valvular Atrial Fibrillation |
title_full_unstemmed | Complex Aortic Arch Atherosclerosis in Acute Ischemic Stroke Patients with Non-Valvular Atrial Fibrillation |
title_short | Complex Aortic Arch Atherosclerosis in Acute Ischemic Stroke Patients with Non-Valvular Atrial Fibrillation |
title_sort | complex aortic arch atherosclerosis in acute ischemic stroke patients with non-valvular atrial fibrillation |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8265927/ https://www.ncbi.nlm.nih.gov/pubmed/32908035 http://dx.doi.org/10.5551/jat.58339 |
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