Impact of the Total Number of Carotid Plaques on the Outcome of Ischemic Stroke Patients with Atrial Fibrillation

• Main Authors: Hyungjong Park, Minho Han, Young Dae Kim, Joonsang Yoo, Hye Sun Lee, Jin Kyo Choi, Ji Hoe Heo, Hyo Suk Nam
• Format: Article
• Language: English
• Published: MDPI AG 2019-11-01
• Series: Journal of Clinical Medicine
• Subjects: atrial fibrillation; cerebral infarction; carotid stenosis; ultrasonography; outcomes
• Online Access: https://www.mdpi.com/2077-0383/8/11/1897

Background: Atrial fibrillation (AF) shares several risk factors with atherosclerosis. We investigated the association between total carotid plaque number (TPN) and long-term prognosis in ischemic stroke patients with AF. Methods: A total of 392 ischemic stroke patients with AF who underwent carotid ultrasonography were enrolled. TPN was assessed using B-mode ultrasound. The patients were categorized into two groups according to best cutoff values for TPN (TPN &#8804; 4 vs. TPN &#8805; 5). The long-term risk of major adverse cardiovascular events (MACE) and mortality according to TPN was investigated using a Cox hazard model. Results: After a mean follow-up of 2.42 years, 113 patients (28.8%) had developed MACE and 88 patients (22.4%) had died. MACE occurred more frequently in the TPN &#8805; 5 group than in the TPN &#8804; 4 group (adjusted hazard ratio [HR], 1.50; 95% confidence interval [CI], 1.01&#8722;2.21; <i>p</i> &lt; 0.05). Moreover, the TPN &#8805; 5 group showed an increased risk of all-cause mortality (adjusted HR, 2.69; 95% CI, 1.40&#8722;5.17; <i>p</i> &lt; 0.05). TPN along with maximal plaque thickness and intima media thickness showed improved prognostic utility when added to the variables of the CHAD₂DS₂-VASc score. Conclusion: TPN can predict the long-term outcome of ischemic stroke patients with AF. Adding TPN to the CHAD₂DS₂-VASc score increases the predictability of outcome after stroke.