Ultrasonographic frequency of complex aortic plaques in patients with atrial fibrillation

Q: What are the key findings of this study?

Abdominal aortic complex aortic plaques were detected in 14.2% of patients with atrial fibrillation, with each 1-point increase in the CHA2DS2-VA score associated with a 2.45-fold increased odds of plaque presence.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Atrial fibrillation (n=748). Intervention: CHA2DS2-VA score (per 1-point increase). Primary outcome: Presence of abdominal aortic complex aortic plaque (AA-CAP) (OR 2.446, 95% CI 1.900-3.149, p=<0.001).

Q: What does this research mean for the field?

Complex abdominal aortic plaques are present in 14.2% of patients with atrial fibrillation and are independently associated with older age, hypertension, and higher CHA₂DS₂-VA scores. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To determine the prevalence of complex abdominal aortic plaques and identify clinical predictors in patients with atrial fibrillation.

Atilla Bulut; Fadime Koca; Yurdaer Dönmez; Hilmi Erdem Sumbul; Mustafa Lütfullah Ardıç; Mevlüt Koç

doi:10.1186/s12872-026-06104-0

June 9, 2026BMC Cardiovascular DisordersOpen Access

Ultrasonographic frequency of complex aortic plaques in patients with atrial fibrillation

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Key result

Each CHA2DS2-VA point in AF is linked to ~145% higher odds of complex abdominal aortic plaques.

OR 2.446
95% CI 1.900-3.149
P<0.001
n=748

Figures

Why the study?

Aortic plaque increases stroke risk in atrial fibrillation, but data on the frequency of abdominal aortic plaques in this population are limited.

What is the prevalence of abdominal aortic complex aortic plaque and its associated parameters in patients with atrial fibrillation?

Key Points

To determine the prevalence of complex abdominal aortic plaques and identify clinical predictors in patients with atrial fibrillation.
Assessed 748 patients with atrial fibrillation (406 men, 342 women; mean age 59.4 ± 12.4 years) without known coronary or peripheral arterial disease.
Evaluated the abdominal aorta for complex aortic plaques using abdominal ultrasonography.
Identified independent predictors using multivariable logistic regression and evaluated diagnostic thresholds using receiver operating characteristic analysis.
Abdominal aortic complex plaques were identified in 106 of 748 patients (14.2%), including 14 patients (1.87%) with isolated plaques that reclassified their CHA₂DS₂-VA score from 0 to 1.
Multivariable logistic regression showed independent associations with age (OR = 1.071, 95% CI: 1.031–1.111, p < 0.001), CHA₂DS₂-VA score (OR = 2.446, 95% CI: 1.900–3.149, p < 0.001), and hypertension (OR = 2.735, 95% CI: 1.441–5.190, p = 0.002).
Cut-off values of 65 years (AUC = 0.842, p < 0.001) and a CHA₂DS₂-VA score of 3 (AUC = 0.852, p < 0.001; 86% sensitivity, 85% specificity) significantly predicted the presence of complex plaques.

Study Design

Type

Cohort (n=748)

Multicenter

No

Structured PICO

What is the prevalence of abdominal aortic complex aortic plaque and its associated parameters in patients with atrial fibrillation?

P

Population

748 adults (mean age 59.4 years, 45.7% female) with atrial fibrillation and no known coronary or peripheral vascular disease who underwent abdominal ultrasonography.

E

Exposure

Abdominal ultrasonography to assess for abdominal aortic complex aortic plaque (AA-CAP)

O

Outcome

Prevalence of abdominal aortic complex aortic plaque (AA-CAP) and its associated clinical parameterssurrogate

Main Result

Odds Ratio: 2.446 (95% CI 1.9–3.149)

p-value: p=<0.001

Limitations

Single-center, non-randomized, retrospective study in a relatively small patient population from a single ethnic region.
Selection bias due to inclusion of a selected population rather than all patients with atrial fibrillation.
Exclusion of patients with previously known coronary artery disease.
Absence of longitudinal follow-up to evaluate long-term outcomes such as mortality and morbidity.
Exclusion of obese patients, who have a higher prevalence of atrial fibrillation and atherosclerosis.
Lack of evaluation of complex aortic plaques in the ascending aorta and absence of carotid plaque assessment.

Implication

Abdominal aortic complex plaque is present in 14.2% of patients with atrial fibrillation and is independently associated with age, hypertension, and CHA₂DS₂-VA score, suggesting abdominal ultrasound may aid in stroke risk stratification.

Abstract

Background The presence of aortic plaque is an important risk factor for stroke in patients with atrial fibrillation (AF). A history of vascular disease, defined as the presence of complex aortic plaque (CAP), constitutes one of the components of the CHA₂DS₂-VA score. However, data regarding the frequency of abdominal aortic (AA) plaques in patients with AF are limited in the literature. Therefore, the present study aimed to investigate the prevalence of AA–CAP and its associated parameters in patients with AF. Method A total of 748-patients with AF who underwent abdominal ultrasonography (US) for aortic plaque assessment were included in this study. In addition to routine clinical evaluations, all patients were assessed for the presence of AA–CAP using US. The study population was subsequently divided into two groups according to the presence or absence of AA–CAP. Result AA–CAP was detected in 106 (14.2%) of the AF patients included in the study. Patients with AA-CAP were older and had higher CHA₂DS₂-VA scores and a greater burden of cardiovascular risk factors. In addition, blood pressure levels and glucose, urea, and creatinine values were higher, whereas hemoglobin levels were lower in patients with AA–CAP. In logistic regression analysis, age, CHA₂DS₂-VA score, and the presence of hypertension were found to be independently associated with AA–CAP (OR = 1.071,95%CI:1.031–1.111,p < 0.001;OR = 2.446,95%CI:1.900–3.149,p < 0.001;OR = 2.735,95%CI:1.441–5.190,p = 0.002). ROC curve analysis demonstrated that age and CHA₂DS₂-VA score, with cut-off values of 65 years and 3, respectively, identified the presence of AA–CAP with acceptable sensitivity and specificity. Conclusion AA–CAP was observed at a considerable rate (14.2%) in patients with AF. Therefore, in AF patients without previously known coronary or peripheral arterial disease, assessment of AA–CAP using abdominal US may be useful for stroke risk stratification and for more accurate calculation of the CHA₂DS₂-VA score.

Discussion

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Cite This Study

Bulut et al. (2026) conducted a cohort in Atrial fibrillation (n=748). CHA2DS2-VA score (per 1-point increase) was evaluated on Presence of abdominal aortic complex aortic plaque (AA-CAP) (OR 2.446, 95% CI 1.900-3.149, p=<0.001). Abdominal aortic complex aortic plaques were detected in 14.2% of patients with atrial fibrillation, with each 1-point increase in the CHA2DS2-VA score associated with a 2.45-fold increased odds of plaque presence.

synapsesocial.com/papers/6a2a553380c8f91e7f39ee15 https://doi.org/10.1186/s12872-026-06104-0

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Ultrasonographic frequency of complex aortic plaques in patients with atrial fibrillation

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Ultrasonographic frequency of complex aortic plaques in patients with atrial fibrillation

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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