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Characteristics and predictors of aortic plaques in patients with transient ischemic attacks and strokes

Abutaher M Yahia1, Jawad F Kirmani, Andrew R Xavier

  • 1Division of Neurocardiology, Department of Neurology and Neurosciences, University of Medicine and Dentistry of New Jersey, 185 South Orange Avenue, MSB H-506, Newark, NJ 07103-2757, USA. yahia25@hotmail.com

Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging
|January 30, 2004
PubMed

Insights

Aortic atheroma, a significant cause of stroke, is prevalent in 59% of patients. Advanced age and coronary artery disease are linked to severe aortic plaque, suggesting TEE screening for stroke patients.

Area of Science:

  • Cardiovascular Medicine
  • Neurology
  • Diagnostic Imaging

Background:

  • Aortic atheroma is a known contributor to ischemic stroke.
  • Detailed characteristics and distribution of aortic plaque in relation to stroke subtypes require further elucidation.

Purpose of the Study:

  • To determine the prevalence and features of aortic atherosclerotic plaque disease.
  • To investigate the association between aortic plaque and cerebrovascular risk factors in patients experiencing cerebral ischemic events.

Main Methods:

  • Prospective study of patients diagnosed with transient ischemic attacks (TIAs) or strokes between July 2000 and August 2001.
  • Transesophageal echocardiography (TEE) was utilized for evaluation.
  • Data collected included demographics, cerebrovascular risk factors, and stroke subtypes.

Main Results:

  • Thoracic aortic atheromas (TAAs) were identified in 59% of 237 patients.
  • Severe (≥4 mm) and complex plaques were present in 33% and 27% of patients, respectively.
  • Increasing age (OR=1.06) and the presence of patent foramen ovale (PFO) (OR=0.35) were significantly associated with aortic plaque severity and complexity.

Conclusions:

  • One-third of TAAs are severe or complex, predominantly in the descending and arch aorta.
  • Transesophageal echocardiography (TEE) is recommended for early detection and management of TAA in stroke patients with unidentified causes.
Abstract

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