title: Effects of medical treatment on the prognosis and risk of embolic events in patients with severe aortic plaque.
abstract: OBJECTIVE
  The optimal treatment strategy for patients with aortic atheroma is not well established because data regarding medical treatment for such patients are lacking, especially with respect to the Japanese population. The purpose of this study was to clarify the effects of medical treatment on the risk of embolic events and mortality in patients with severe aortic plaque.
  
  
  METHODS
  We retrospectively investigated 75 consecutive patients with severe aortic plaque detected on transesophageal echocardiography (TEE) between 1995 and 2005. The occurrence of embolic events and all-cause death in the period after TEE was assessed. The cumulative incidence of subsequent embolic events and death was evaluated in relation to specific medical treatments, including statins, antiplatelet drugs and warfarin.
  
  
  RESULTS
  Embolic events occurred in 27 patients (36%) and death occurred in 37 patients (49%) during follow-up (5.6±3.0 years). The patients who experienced embolic events had a significantly higher prevalence of previous embolic events, atrial fibrillation and hemodialysis than the patients who did not experience embolic events. Univariate and multivariate analyses showed that the use of statins and/or antiplatelet drugs was significantly associated with a low incidence of death but not with a low incidence of embolic events. On the other hand, warfarin exhibited neither beneficial nor harmful effects on the incidence of embolic events or death.
  
  
  CONCLUSIONS
  Statin and antiplatelet drugs have beneficial effects on the prognosis of patients with severe aortic plaque diagnosed on TEE.
authors: Department of Cardiology, Tenri Hospital.
authors: Masataka
authors: M
authors: Nishiga
authors: Chisato
authors: C
authors: Izumi
authors: Hayato
authors: H
authors: Matsutani
authors: Sumiyo
authors: S
authors: Hashiwada
authors: Shuichi
authors: S
authors: Takahashi
authors: Yukiko
authors: Y
authors: Hayama
authors: Seiko
authors: S
authors: Nakajima
authors: Jiro
authors: J
authors: Sakamoto
authors: Koji
authors: K
authors: Hanazawa
authors: Makoto
authors: M
authors: Miyake
authors: Toshihiro
authors: T
authors: Tamura
authors: Hirokazu
authors: H
authors: Kondo
authors: Makoto
authors: M
authors: Motooka
authors: Kazuaki
authors: K
authors: Kaitani
authors: Yoshihisa
authors: Y
authors: Nakagawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000473:pathology; D001018:Aortic Diseases / Q000150:complications* / Q000175:diagnosis*; D001281:Atrial Fibrillation / Q000150:complications; D003645:Death, Sudden; D017548:Echocardiography, Transesophageal; D004617:Embolism / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D007564:Japan; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D015995:Prevalence; D011379:Prognosis; D012044:Regression Analysis; D006435:Renal Dialysis; D012189:Retrospective Studies; D012306:Risk; D020521:Stroke / Q000150:complications / Q000175:diagnosis; D016896:Treatment Outcome; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors; D014859:Warfarin