Key result
In patients with atrial fibrillation, the presence of aortic atherosclerotic plaque ≥ 4.0 mm was a significant predictor of long-term cardiovascular events (HR 2.6; 95% CI 1.1-6.0; P=0.02).
Why the study?
Does the presence of aortic atherosclerotic plaque ≥ 4.0 mm predict cardiovascular events in patients with atrial fibrillation?
Cohort (n=108)
Does the presence of aortic atherosclerotic plaque ≥ 4.0 mm predict cardiovascular events in patients with atrial fibrillation?
Effect estimate: HR 2.6 (95% CI 1.1-6.0)
p-value: p=0.02
In patients with atrial fibrillation, the presence of aortic atherosclerotic plaque ≥4.0 mm on transesophageal echocardiography is an independent predictor of long-term cardiovascular events.
Aortic plaque ≥4 mm may refine CV risk stratification in AF; leaves open whether screening or targeted therapy improves outcomes.
BACKGROUND: Both left atrial spontaneous echo contrast (LASEC) and aortic atherosclerotic plaque (AoP) ≥ 4.0 mm in thickness are predictors of cardiovascular events after stroke. The aim of this study was to investigate impact of AoP ≥ 4.0 mm or LASEC on cardiovascular events in patients with atrial fibrillation (AF). METHODS AND RESULTS: One hundred and eight consecutive patients with AF were enrolled and studied. Patients were grouped according to the presence or absence of AoP ≥ 4.0 mm in the proximal aortic arch on transesophageal echocardiography (TEE). Cardiovascular events included death, myocardial infarction, ischemic stroke, systemic embolism and congestive heart failure. During a follow-up period (median, 3.9 years), cardiovascular event-free survival rate was significantly lower in patients with AoP ≥ 4.0 mm than in patients without AoP ≥ 4.0 mm (log-rank, P=0.01). In contrast, patients with LASEC showed a trend toward lower cardiovascular event-free survival than those without LASEC (log-rank, P=0.10). Univariate TEE predictors of cardiovascular events were AoP ≥ 4.0 mm, LASEC and left atrial appendage flow velocity. On multivariate Cox regression analysis, AoP ≥ 4.0 mm was the only TEE predictor of cardiovascular events during follow-up (P=0.02, hazard ratio, 2.6; 95% confidence interval: 1.1-6.0). CONCLUSIONS: In the present unselected patients with AF, AoP predicted long-term cardiovascular events.
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Okura et al. (2013) conducted a cohort in Atrial Fibrillation (n=108). Aortic atherosclerotic plaque (AoP) ≥ 4.0 mm vs. Absence of AoP ≥ 4.0 mm was evaluated on Cardiovascular events (death, myocardial infarction, ischemic stroke, systemic embolism and congestive heart failure) (HR 2.6, 95% CI 1.1-6.0, p=0.02). In patients with atrial fibrillation, the presence of aortic atherosclerotic plaque ≥ 4.0 mm was a significant predictor of long-term cardiovascular events (HR 2.6; 95% CI 1.1-6.0; P=0.02).
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