Relationship between atherosclerotic risk factors and aortic plaques in patients with first-ever ischaemic stroke

Heart Lung Circ. 2014 Oct;23(10):930-5. doi: 10.1016/j.hlc.2014.02.013. Epub 2014 Mar 22.

Abstract

Objective: Aortic plaque is considered a risk factor of ischaemic stroke, and both ulceration and plaque thickness are considered important. However, the relative importance of aortic plaque and carotid plaque remains unclear. The purpose of this study is to clarify the relation between aortic and carotid plaque lesions and atherosclerotic risk factors in patients with acute ischaemic stroke.

Methods: We enrolled 76 patients with first-ever ischaemic stroke, undergoing transoesophageal echocardiography, whose aetiology of ischaemic stroke was unknown. We divided the patients into two groups according to aortic plaque thickness, based on previous reports, i.e., a high-risk group (over 4mm) and a low-risk group (less than 4mm). We also examined several atherosclerotic risk factors.

Results: Mean age, gender and hypertension was not significantly different between the low-risk and high-risk group. HDL-cholesterol (P<0.01), LDL/HDL ratio (P<0.05), non-HDL-cholesterol (P<0.05), HbA1c (P<0.05) and eGFR (P<0.01) were significantly different between the two groups. Max plaque thickness in the carotid artery was correlated with aortic plaque lesions.

Conclusion: Multiple atherosclerotic risk factors are associated with greater aortic plaque lesions. Aortic plaque is important not only as an embolic source, but also as one of the atherosclerotic markers.

Keywords: Aortogenic brain embolism; Artery-to-artery embolism; Carotid plaque; Chronic kidney disease; Transoesophageal echocardiography.

MeSH terms

  • Aged
  • Aorta / diagnostic imaging*
  • Atherosclerosis / blood
  • Atherosclerosis / diagnostic imaging*
  • Brain Ischemia / etiology*
  • Carotid Arteries / diagnostic imaging*
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Echocardiography, Transesophageal
  • Female
  • Glomerular Filtration Rate
  • Glycated Hemoglobin / metabolism
  • Humans
  • Male
  • Middle Aged
  • Risk Factors
  • Stroke / etiology*

Substances

  • Cholesterol, HDL
  • Cholesterol, LDL
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human