Aortic Arch Plaques More Prevalent in Aortic Stenosis

Complex plaques in patients with aortic stenosis are associated with risk of cerebral infarction

THURSDAY, Sept. 22 (HealthDay News) -- Patients with severe aortic stenosis (AS) have a greater prevalence of aortic arch plaques and complex arch plaques, with the presence of complex plaques independently associated with the risk of cerebral infarction, according to a study published in the Oct. 1 issue of The American Journal of Cardiology.

Kenichi Sugioka, M.D., from Osaka City University Graduate School of Medicine in Japan, and colleagues investigated the prevalence of aortic arch plaques and their association with the risk of cerebral infarction in 116 patients (55 men; mean age, 71 ± 7 years; mean aortic valve area, 0.68 ± 0.15 cm²) with severe AS, scheduled for aortic valve replacement. Transesophageal echocardiography was used to assess the presence, thickness, and morphology of the aortic arch plaques. All patients were evaluated for cerebral infarcts.

Compared to age- and gender-matched control subjects, the investigators found that patients with severe AS had significantly more aortic arch plaques (74 versus 41 percent) and complex arch plaques (30 versus 10 percent), including large plaques (>4 mm), ulcerated plaques, and mobile plaques. Multivariate logistic analyses revealed a significant independent association between the presence of complex arch plaques and cerebral infarction in patients with AS, after adjusting for standard atherosclerotic risk factors and coronary artery disease (odds ratio, 8.46).

"There is a greater prevalence of aortic arch plaques in patients with AS and that the presence of complex plaques is independently associated with cerebral infarction in these patients," the authors write.

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