Short-term evolution (9 months) of aortic atheroma in patients with or without embolic events: a follow-up transoesophageal echocardiographic study.
OBJECTIVE
The influence of clinical risk factors and therapeutic options on aortic plaque changes is unknown. In this study, we have evaluated aortic atheroma (AA) evolution in patients with and without embolic events.


RESULTS
We enrolled 83 patients (mean age 67.9+/-8.6 years). All patients were studied with transoesophageal echocardiography at baseline and 9 months after enrolment. Baseline atherosclerotic plaques were defined as uncomplicated (between 1 and 3.9 mm) and complicated aortic plaques (>or=4 mm). To minimize sub-millimetre errors in plaque evolution, AA progression was defined as an increase in maximal plaque thickness>or=1 mm. Similarly, regression was defined as a decrease in maximal thickness of atheromatous plaque>or=1 mm. Aortic plaques were classified as uncomplicated in 20.5% and complicated in 79.5% of patients. Fifty-five plaques (47.8%), both complicated and uncomplicated, remained unchanged. Conversely, 16 plaques (13.9%) increased (mean plaque thickness from 3.94+/-1.39 to 5.56+/-1.41 mm, P<0.001) and 44 (38.3%) decreased (mean plaque thickness from 5.25+/-1.52 to 3.79+/-1.53 mm, P<0.001). Multinomial logistic regression procedure suggests that statins increase the probability of plaque thickness reduction (OR 5.92, 95% CI 1.27-27.7, P=0.024) and decrease the probability of plaque progression (OR 0.03, 95% CI 0.01-0.28, P=0.002).


CONCLUSIONS
This study suggests that statins may reduce the risk of AA progression.
De Castro
Stefano
S
Department of Cardiovascular, Respiratory and Morphological Sciences, University of Rome La Sapienza, Policlinico Umberto I degrees, Viale del Policlinico, 155, 00161 Rome, Italy. stefano.decastro@uniroma1.it
Di Angelantonio
Emanuele
E
Celotto
Annalisa
A
Fiorelli
Marco
M
Passaseo
Ilaria
I
Papetti
Federica
F
Caselli
Stefano
S
Marcantonio
Andrea
A
Cohen
Ariel
A
Pandian
Natesa
N
D000368:Aged; D000704:Analysis of Variance; D000925:Anticoagulants / Q000627:therapeutic use; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging*; D050197:Atherosclerosis / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology; D000069059:Atorvastatin; D016001:Confidence Intervals; D017548:Echocardiography, Transesophageal / Q000379:methods*; D004617:Embolism / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011446:Prospective Studies; D011758:Pyrroles / Q000627:therapeutic use*; D018570:Risk Assessment; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
D000925:Anticoagulants; D006538:Heptanoic Acids; D011758:Pyrroles; D000069059:Atorvastatin