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Risk factors for progression of aortic atheroma in stroke and transient ischemic attack patients

Souvik Sen1, Stephen M Oppenheimer, Joao Lima

  • 1Cerebrovascular Program, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Md, USA.

Stroke
|April 6, 2002
PubMed

Insights

Elevated homocysteine levels are linked to aortic atheroma progression in stroke patients. Assessing and treating high homocysteine may help slow the advancement of this cardiovascular risk factor.

Area of Science:

  • Cardiovascular research
  • Neurology
  • Vascular medicine

Background:

  • Aortic atheroma is a known stroke risk factor with unknown progression factors.
  • Hyperhomocysteinemia is implicated in atherosclerosis, including cerebral vasculature.

Purpose of the Study:

  • Investigate associations between elevated homocysteine, stroke risk factors, and aortic atheroma progression.
  • Determine clinical and risk factor associations of aortic atheroma progression in cerebrovascular disease patients.

Main Methods:

  • 78 patients with cerebrovascular disease underwent transesophageal echocardiograms at baseline and 9 months.
  • Aortic atheroma was graded; stroke risk factors and treatments were recorded.
  • Patients were stratified by aortic atheroma progression status.

Main Results:

  • Aortic atheroma progression occurred in 37% of patients, most notably in the aortic arch.
  • Elevated homocysteine levels (≥14.0 µmol/L), total anterior cerebral infarct, and large-artery atherosclerosis significantly correlated with progression.
  • No baseline atheroma was observed in two-thirds of patients with unchanged atheroma over 9 months.

Conclusions:

  • Elevated homocysteine levels are a significant vascular risk factor associated with aortic atheroma progression.
  • Stroke and transient ischemic attack patients with aortic atheroma warrant homocysteine assessment.
  • Vitamin treatment for elevated homocysteine may help arrest aortic atheroma progression.
Abstract

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