The DOI matches its Crossref record; 18 of the 18 references it cites were found in a registry or an index.
Aortic Plaque Morphology and Vascular Events: A Follow-up Study in Patients With Ischemic Stroke
Abstract
Background Atherosclerotic disease of the aortic arch has been found to be associated with the risk of ischemic stroke. We have shown that atherosclerotic plaques ≥4 mm in thickness in the ascending aorta and proximal arch detected by transesophageal echocardiography are a risk factor for ischemic stroke. The purpose of this study was to evaluate the impact, if any, of plaque morphology (ulceration, hypoechoic plaques or calcification) on the risk of subsequent vascular events. Methods and Results We followed for a period of 2 to 4 years, a cohort of 334 patients 60 years or older who were consecutively admitted with brain infarction and who had transesophageal echocardiography. The risk of vascular events in patients with plaques in the aortic arch according to the presence of surface ulceration, calcifications, and sessile or mobile thrombus was estimated during a total of 788 person-years of follow-up. Hypoechoic plaques, calcifications, and ulceration were more frequently found in patients with plaques ≥4 mm as compared with those with plaques <4 mm. The presence of ulceration did not increase the relative risk of vascular events in patients with plaque ≥4 mm (the relative risk was 4.3 [ P <.001] in those with ulceration and 5.7 [ P <.001]) in those without ulceration. The lack of calcification did increase the risk of vascular events in patients with plaque ≥4 mm. The highest relative risk of events was found among the patients with noncalcified plaques (relative risk, 10.3; 95% confidence interval, 4.2 to 25.2; P <.001). The risk of events was systematically higher in patients without calcifications than in patients with calcifications regardless of what other morphological features were considered. Conclusions In patients with brain infarction, the risk associated with aortic plaque thickness (≥4 mm) is markedly increased by the absence of plaque calcifications. These findings are important for the design of therapeutic trials in such patients.
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Cites
Falk, E., Shah, P. K., & Fuster, V. (1995) · Circulation · doi:10.1161/01.cir.92.3.657 · Cited by 3,536
Intimal plus medial thickness of the arterial wall: a direct measurement with ultrasound imaging.
Pignoli, P., Tremoli, E., Poli, A., Oreste, P., & Paoletti, R. (1986) · Circulation · doi:10.1161/01.cir.74.6.1399 · Cited by 2,404
Atherosclerotic Disease of the Aortic Arch and the Risk of Ischemic Stroke
Amarenco, P., Cohen, A., Tzourio, C., Bertrand, B., Hommel, M., Besson, G., Chauvel, C., Touboul, P.-J., & Bousser, M.-G. (1994) · New England Journal of Medicine · doi:10.1056/nejm199412013312202 · Cited by 1,008
Self-citationToussaint, J.-F., LaMuraglia, G. M., Southern, J. F., Fuster, V., & Kantor, H. L. (1996) · Circulation · doi:10.1161/01.cir.94.5.932 · Cited by 668
The Prevalence of Ulcerated Plaques in the Aortic Arch in Patients with Stroke
Amarengo, P., Duyckaerts, C., Tzourio, C., Hénin, D., Bousser, M.-G., & Hauw, J.-J. (1992) · New England Journal of Medicine · doi:10.1056/nejm199201233260402 · Cited by 577
Self-citationAtherosclerotic Disease of the Aortic Arch as a Risk Factor for Recurrent Ischemic Stroke
(1996) · New England Journal of Medicine · doi:10.1056/nejm199605093341902 · Cited by 575
Recognition and embolic potential of intraaortic atherosclerotic debris
Karalis, D. G., Chandrasekaran, K., Victor, M. F., Ross, J. J., & Mintz, G. S. (1991) · Journal of the American College of Cardiology · doi:10.1016/0735-1097(91)90706-f · Cited by 444
Atherosclerotic Disease of the Aortic Arch as a Risk Factor for Recurrent Ischemic Stroke
(1996) · New England Journal of Medicine · doi:10.1056/nejm199611073351913 · Cited by 427
High risk for vascular events in patients with protruding aortic atheromas: A prospective study
Tunick, P. A., Rosenzweig, B. P., Katz, E. S., Freedberg, R. S., Perez, J. L., & Kronzon, I. (1994) · Journal of the American College of Cardiology · doi:10.1016/0735-1097(94)90595-9 · Cited by 308
Proximal aortic atheroma. An independent risk factor for cerebral ischemia.
Jones, E. F., Kálmán, J., Calafiore, P. A., Tonkin, A. M., & Donnan, G. A. (1995) · PubMed · Cited by 240
Cited by
Kernan, W. N., Ovbiagele, B., Black, H. R., Bravata, D. M., Chimowitz, M. I., Ezekowitz, M. D., Fang, M. C., Fisher, M., Furie, K. L., Heck, D. V., et al. (2014) · Stroke · doi:10.1161/str.0000000000000024 · Cited by 5,170
Kleindorfer, D. O., Towfighi, A., Chaturvedi, S., Cockroft, K. M., Gutierrez, J., Lombardi-Hill, D., Kamel, H., Kernan, W. N., Kittner, S. J., Leira, E. C., et al. (2021) · Stroke · doi:10.1161/str.0000000000000375 · Cited by 3,237
WRITING GROUP MEMBERS, Hiratzka, L. F., Bakris, G. L., Beckman, J. A., Bersin, R. M., Carr, V. F., Casey, D. E., Eagle, K. A., Hermann, L. K., Isselbacher, E. M., et al. (2010) · Circulation · doi:10.1161/cir.0b013e3181d4739e · Cited by 2,289
Goldstein, S. A., Evangelista, A., Abbara, S., Arai, A., Asch, F. M., Badano, L. P., Bolen, M. A., Connolly, H. M., Cuéllar-Calàbria, H., Czerny, M., et al. (2015) · Journal of the American Society of Echocardiography · doi:10.1016/j.echo.2014.11.015 · Cited by 641
Johnsen, S. H., Mathiesen, E. B., Joakimsen, O., Stensland, E., Wilsgaard, T., Løchen, M.-L., Njølstad, I., & Arnesen, E. (2007) · Stroke · doi:10.1161/strokeaha.107.487264 · Cited by 398
Metadata
- Authors
- Cohen, A., Tzourio, C., Bertrand, B., Chauvel, C., Bousser, M.-G., & Amarenco, P.
- Venue
- Circulation
- Published
- 1997-12-02
- Volume
- 96
- Issue
- 11
- Pages
- 3838-3841
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2052303206
- Cited by
- 278
- References
- 18
- FWCI
- 9.41
- Type
- journal article
- Language
- en
- Open access
- closed
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- Cohen, A., Tzourio, C., Bertrand, B., Chauvel, C., Bousser, M.-G., & Amarenco, P. (1997). Aortic Plaque Morphology and Vascular Events: A Follow-up Study in Patients With Ischemic Stroke. Circulation. https://doi.org/10.1161/01.cir.96.11.3838
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