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Thoracic aortic atheroma severity predicts high-risk coronary anatomy in patients undergoing transesophageal

Xuedong Shen1, Wilbert S Aronow, Chandra K Nair

  • 1Cardiac Center of Creighton, University School of Medicine, Omaha, Nebraska, USA.

Archives of Medical Science : AMS
|February 1, 2012
PubMed

Insights

Severe thoracic aortic atheroma (AA) significantly increases the risk of high-risk coronary anatomy (HRCA). This condition also correlates with a higher risk of all-cause mortality, underscoring its clinical importance.

Area of Science:

  • Cardiovascular Medicine
  • Diagnostic Imaging
  • Interventional Cardiology

Background:

  • Atherosclerotic disease can affect multiple arterial beds.
  • The relationship between thoracic aortic atheroma (AA) and high-risk coronary anatomy (HRCA) requires further investigation.

Purpose of the Study:

  • To investigate the association between the severity of thoracic aortic atheroma (AA) and the prevalence of high-risk coronary anatomy (HRCA).

Main Methods:

  • Transesophageal echocardiography was used to assess AA severity in 187 patients.
  • Coronary angiography identified HRCA, defined as left main coronary artery stenosis ≥ 50% or significant 3-vessel disease (≥ 70% narrowing).

Main Results:

  • High-risk coronary anatomy (HRCA) was present in 24% of patients.
  • Aortic atheroma (AA) severity grade > II predicted HRCA with 76% sensitivity and 81% specificity (AUC 0.83, p=0.0001).
  • AA > grade II was independently associated with HRCA (OR=7.5, p<0.0001) and significantly reduced survival during 41-month follow-up (p=0.002).

Conclusions:

  • Thoracic aortic atheroma (AA) severity grade > II is a strong predictor of high-risk coronary anatomy (HRCA).
  • Patients with AA > grade II face a 7.5-fold increased risk of HRCA and exhibit significantly reduced all-cause mortality.
Abstract

Keywords:
coronary angiographyhigh-risk coronary anatomythoracic aortic atheromatransesophageal echocardiography

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