Predictors of Complex Aortic Plaques in Patients Undergoing Transoesophageal Echocardiography

• Main Authors: Eser Durmaz, Bilgehan Karadağ, Cansu Ebren, Burçak Kılıçkıran Avcı, Burak Koçak, Ece Yurtseven, Damla Koca, Utku Raimoğlu, Mehmet Semih Belpınar, Zeki Öngen
• Format: Article
• Language: English
• Published: Galenos Yayinevi 2020-11-01
• Series: İstanbul Medical Journal
• Subjects: complex aortic plaques; cha2ds2-vasc score; ischaemic stroke
• Online Access: http://istanbulmedicaljournal.org/archives/archive-detail/article-preview/predictors-of-complex-aortic-plaques-in-patients-u/41826

Introduction:Atrial fibrillation (AF) is one of the most important causes of ischaemic stroke according to the TOAST classification. The CHA2DS2-VASc score is a widely used scoring system for estimating systemic thromboembolism in patients with non-valvular AF. TOAST classification indicates that an ischaemic stroke may also be due to large artery atherosclerosis. Since some of the atherosclerotic risk factors also occur in the CHA2DS2-VASc scoring system, we hypothesised that this scoring system can also predict the presence of complex aortic plaques and their stroke risk.Methods:We retrospectively investigated 551 patients who underwent transthoracic echocardiography and subsequent transoesophageal echocardiography (TEE). Baseline characteristics of the patients were recorded, and theCHA2DS2-VASc score was calculated before the TEE examination. Aortic plaques are classified as complex when they are protruding more than 4 mm, mobile or have irregular boundaries.Results:Among 551 patients, 110 complex aortic plaques (CAPs) were detected. Considering all the patients, higher CHA2DS2-VASc score [odds ratio (OR): 2.905], increasing age (OR: 1.056), and male (OR: 3.008) were significantly associated with CAP. CHA2DS2-VASc score was even more significantly associated with CAP in patients with a previous stroke [p<0.001, OR: 16.754 (4.196-66.894), confidence interval (CI): 95%]. After excluding complicated aortic plaques from the calculation, higher CHA2DS2-VASc score in patients with AF was also associated with the presence of CAPs (p<0.001, OR: 3.379 1.848-6.179, CI: 95%).Conclusion:Although the CHA2DS2-VASc score has been validated to estimate thromboembolic risk in patients with non-valvular AF, the results of this study show that a high CHA2DS2-VASc score may also indicate an increased risk for CAP in patients with both sinus and non-valvular-AF rhythm.