OBJECTIVE: Aortic arch atheroma (AAA) is associated with vascular risk factors and with stroke risk. Its prevalence and prognosis remain to be defined in patients with transient ischemic attack (TIA). METHODS: Using data from the SOS-TIA registry, we assessed the prevalence of AAA detected by transesophageal echocardiography (TEE). AAA was graded as moderate (<4 mm) or severe (≥4 mm). All patients had a standardized work-up investigation and were followed for 1 year. RESULTS: Between January 2003 and December 2008, 1850 patients with definite/possible TIA or minor stroke were enrolled and 1231 (67%) underwent TEE. Moderate AAA was found in 26% of patients (n = 324) and severe AAA in 14% (n = 171), giving an overall AAA prevalence of 40%. Among the 873 patients without identified cause of TIA, the prevalence of moderate and severe AAA were 24% and 12% respectively. Intracranial or extracranial stenosis ≥50% were detected in 21% of patients and were independently associated with AAA (adjusted odds ratio, 1.65, 95% confidence interval (CI), 1.23-2.22). At one-year, incidence of recurrent vascular events was 2.2% in patients without AAA, 4.1% in moderate AAA and 6.6% in severe AAA (log-rank, p for trend = 0.003). Using patients without AAA as reference, and after adjustment on vascular risk factors, the hazard ratio (95% CI) for moderate was 1.36 (0.62-2.99) and 2.08 (0.89-4.86) for severe (p for trend = 0.095). CONCLUSIONS: These findings support a systematic identification of AAA in TIA patients to optimize risk stratification in this specific population.
OBJECTIVE: Aortic arch atheroma (AAA) is associated with vascular risk factors and with stroke risk. Its prevalence and prognosis remain to be defined in patients with transient ischemic attack (TIA). METHODS: Using data from the SOS-TIA registry, we assessed the prevalence of AAA detected by transesophageal echocardiography (TEE). AAA was graded as moderate (<4 mm) or severe (≥4 mm). All patients had a standardized work-up investigation and were followed for 1 year. RESULTS: Between January 2003 and December 2008, 1850 patients with definite/possible TIA or minor stroke were enrolled and 1231 (67%) underwent TEE. Moderate AAA was found in 26% of patients (n = 324) and severe AAA in 14% (n = 171), giving an overall AAA prevalence of 40%. Among the 873 patients without identified cause of TIA, the prevalence of moderate and severe AAA were 24% and 12% respectively. Intracranial or extracranial stenosis ≥50% were detected in 21% of patients and were independently associated with AAA (adjusted odds ratio, 1.65, 95% confidence interval (CI), 1.23-2.22). At one-year, incidence of recurrent vascular events was 2.2% in patients without AAA, 4.1% in moderate AAA and 6.6% in severe AAA (log-rank, p for trend = 0.003). Using patients without AAA as reference, and after adjustment on vascular risk factors, the hazard ratio (95% CI) for moderate was 1.36 (0.62-2.99) and 2.08 (0.89-4.86) for severe (p for trend = 0.095). CONCLUSIONS: These findings support a systematic identification of AAA in TIA patients to optimize risk stratification in this specific population.
Authors: F Purroy; P E Jiménez Caballero; A Gorospe; M J Torres; J Alvarez-Sabin; P Martínez-Sánchez; D Cánovas; M Freijo; J A Egido; J M Ramírez-Moreno; A Alonso-Arias; A Rodríguez-Campello; I Casado-Naranjo; J Martí-Fàbregas; Y Silva; P Cardona; A Morales; A García-Pastor; J F Arenillas; T Segura; C Jiménez; J Masjuán Journal: J Neurol Date: 2014-06-10 Impact factor: 4.849
Authors: P Assemat; K K Siu; J A Armitage; S N Hokke; A Dart; J Chin-Dusting; K Hourigan Journal: Comput Struct Biotechnol J Date: 2014-08-02 Impact factor: 7.271