Open AccessImpact of Concomitant Coronary Artery Disease on Atherosclerotic Plaques in the Aortic Arch in Patients With Severe Aortic Stenosis
Author(s) -
Fujita Suwako,
Sugioka Kenichi,
Matsumura Yoshiki,
Ito Asahiro,
Hozumi Takeshi,
Hasegawa Takao,
Hanatani Akihisa,
Naruko Takahiko,
Ueda Makiko,
Yoshiyama Minoru
Publication year - 2013
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.22121
Subject(s) - medicine , aortic arch , concomitant , cardiology , coronary artery disease , stenosis , stroke (engine) , population , aortic valve stenosis , aorta , mechanical engineering , environmental health , engineering
Abstract Background Coronary artery disease ( CAD ) often occurs concurrently in patients with severe aortic stenosis ( AS ). However, the influence of concomitant CAD on the presence of atherosclerotic complex plaques in the aortic arch, which is associated with increased stroke risk, has not been fully assessed in patients with severe AS . Hypothesis We hypothesized that concomitant CAD would be associated with the presence of complex arch plaques in patients with severe AS . Methods The study population consisted of 154 patients with severe AS who had undergone transesophageal echocardiography ( TEE ) and coronary angiography (71 male; mean age, 72 ± 8 years; mean aortic valve area, 0.67 ± 0.15 cm 2 ). Aortic arch plaques were assessed using TEE , and complex arch plaques were defined as large plaques (≥4 mm), ulcerated plaques, or mobile plaques. Results The prevalence of aortic arch plaques (87% vs 70%; P = 0.03) and complex arch plaques (48% vs 20%; P < 0.001) was significantly greater in AS patients with CAD than in those without CAD . After adjustment for traditional atherosclerotic risk factors, we found that concomitant CAD was independently associated with the presence of complex arch plaques (odds ratio: 2.86, 95% confidence interval: 1.23‐6.68, P = 0.01). Conclusions In patients with severe AS , concomitant CAD is associated with severe atherosclerotic burden in the aortic arch. This observation suggests that AS patients with concomitant CAD are at a higher risk for stroke, and that careful evaluation of complex arch plaques by TEE is needed for the risk stratification of stroke in these patients.