European Journal of Echocardiography Advance Access published online on May 30, 2008
European Journal of Echocardiography, doi:10.1093/ejechocard/jen172
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Short-term evolution (9 months) of aortic atheroma in patients with or without embolic events: a follow-up transoesophageal echocardiographic study
1 Department of Cardiovascular, Respiratory and Morphological Sciences, University of Rome ‘La Sapienza’, Policlinico Umberto I°, Viale del Policlinico, 155, 00161 Rome, Italy
2 Department of Neurological Sciences, University of Rome ‘La Sapienza’, Rome, Italy
3 Department of Cardiology, Saint Antoine University Hospital, Université Paris VI, Paris, France
4 Tufts University, New England Medical Center, Boston, MA, USA
Received 12 December 2007; accepted after revision 7 May 2008.
* Corresponding author. Tel: +39 06 4997 9050; fax: +39 06 4997 5060. E-mail address: stefano.decastro{at}uniroma1.it
 |
Abstract |
|---|
Aims: The influence of clinical risk factors and therapeutic options on aortic plaque changes is unknown. In this study, we have evaluated aortic atheroma (AA) evolution in patients with and without embolic events.
Methods and results: We enrolled 83 patients (mean age 67.9 ± 8.6 years). All patients were studied with transoesophageal echocardiography at baseline and 9 months after enrolment. Baseline atherosclerotic plaques were defined as uncomplicated (between 1 and 3.9 mm) and complicated aortic plaques (
4 mm). To minimize sub-millimetre errors in plaque evolution, AA progression was defined as an increase in maximal plaque thickness 1 mm. Similarly, regression was defined as a decrease in maximal thickness of atheromatous plaque 1 mm. Aortic plaques were classified as uncomplicated in 20.5% and complicated in 79.5% of patients. Fifty-five plaques (47.8%), both complicated and uncomplicated, remained unchanged. Conversely, 16 plaques (13.9%) increased (mean plaque thickness from 3.94 ± 1.39 to 5.56 ± 1.41 mm, P < 0.001) and 44 (38.3%) decreased (mean plaque thickness from 5.25 ± 1.52 to 3.79 ± 1.53 mm, P < 0.001). Multinomial logistic regression procedure suggests that statins increase the probability of plaque thickness reduction (OR 5.92, 95% CI 1.27–27.7, P = 0.024) and decrease the probability of plaque progression (OR 0.03, 95% CI 0.01–0.28, P = 0.002).
Conclusion: This study suggests that statins may reduce the risk of AA progression.
Keywords: Echocardiography; Aortic atheroma; Plaque