Aortic Atheromatosis: A Cardiovascular Risk Indicator

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Abstract

Objective

To assess the relationship between diffuse atheromatous disease of the thoracic aorta and cardiovascular events, occurring previously and during follow-up; i.e., death of cardiovascular origin, severe coronary artery disease (acute myocardial infarction or revascularization), peripheral arterial dis-ease and embolism.

Methods

Five hundred transesophageal echocardiograms performed between 1994 and 1998 were retrospectively evaluated. We selected a group of 50 patients (group I) with diffuse atheromatous aortic disease, and a control group of 35 patients (group II) with-out atheromatous aortic disease. Subjects with iso-lated flat plaques and other potential sources of embolism, such as spontaneous echo contrast, thrombus, aneurysm of the inter-atrial septum, mobile vegetations, rheumatic mitral disease or chronic atrial fibrillation were excluded.

Results

In group I, 22 patients had flat plaques, 22 exhibited sessile protruding plaques and 6 had complicated plaques. The prevalence of severe coronary artery disease was 34% for group I and 9% for groupII (p = 0.007); as to the history of embolism, it was32% in group I and 9% in group II. Follow-up was401 ± 303 days (5-1265 days) in group I, and 617 ±357 days (153-1320 days) in group II. There were no significant differences relative to age (group I:68 ± 10 years; group II: 66 ± 7 years), sex, coronary risk factors or ventricular function between both groups. The frequency of cardiovascular events during follow-up for group I was the following: 9 patients (18%) died due to cardiovascular causes, 6 patients (12%) suffered embolic events, and an-other 8 patients (16%) had severe coronary artery disease. In group II there were no cardiovascular deaths, no embolic events and no evidence of severe coronary artery disease.

Conclusions

1) Patients with diffuse atheromatous disease of the thoracic aorta constitute a group of higher cardiovascular risk, associated with a greater incidence of embolism, severe coronary artery disease and greater mortality during follow-up. 2) This finding in a transesophageal echocardiogram was associated with a more frequent history of cardiovascular events.