Vascular events during follow-up in patients with aortic arch atherosclerosis.
OBJECTIVE
An association between aortic arch atherosclerosis and vascular events has been demonstrated. However, few data exist regarding follow-up evaluation of this disease.


METHODS
In this study, 183 patients with the diagnosis of aortic arch atherosclerosis were prospectively followed up. This diagnosis was made during an echocardiographic cross-sectional study. In 136 patients, raised plaques with thickness < 5 mm had been shown to exist, and in 47 patients complex plaques with thickness > or = 5 mm or plaques with mobile components had been demonstrated on the initial transesophageal echocardiography.


RESULTS
During a mean follow-up period of 16 +/- 7 months, vascular events with a presumed embolic origin occurred in 15 patients. The incidence was 4.1 per 100 person-years in patients with raised plaques compared with 13.7 per 100 person-years in the group with complex plaques. The Kaplan-Meier survival analysis revealed a significantly higher rate of vascular events in patients who were found to have complex plaques (P < .01). In the Cox proportional hazards analysis, the finding of complex plaques (relative risk [RR], 4.3; 95% confidence interval [CI], 1.5 to 12.0; P = .006), coronary artery disease (RR, 4.0; 95% CI, 1.2 to 13.1; P = .02), and a history of previous embolism (RR, 4.0; 95% CI, 1.1 to 14.4; P = .03) were independent predictors of vascular events.


CONCLUSIONS
Patients with the finding of protruding plaques or plaques with mobile components have a high risk of subsequent vascular events.
Mitusch
R
R
Medical Department of Cardiology, University of Lübeck, Germany.
Doherty
C
C
Wucherpfennig
H
H
Memmesheimer
C
C
Tepe
C
C
Stierle
U
U
Kessler
C
C
Sheikhzadeh
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic; D001161:Arteriosclerosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001281:Atrial Fibrillation / Q000453:epidemiology; D003327:Coronary Disease / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003925:Diabetic Angiopathies / Q000453:epidemiology; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking; D016019:Survival Analysis; D014652:Vascular Diseases / Q000453:epidemiology*