Atherosclerotic plaques in the aortic arch and subclinical cerebrovascular disease

Aylin Tugcu, Zhezhen Jin, Shunichi Homma, Mitchell S V Elkind, Tatjana Rundek, Mitsuhiro Yoshita, Charles Decarli, Koki Nakanishi, Sofia Shames, Clinton B Wright, Ralph L Sacco, Marco R. Di Tullio

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background and Purpose - Aortic arch plaque (AAP) is a risk factor for ischemic stroke, but its association with subclinical cerebrovascular disease is not established. We investigated the association between AAP and subclinical cerebrovascular disease in an elderly stroke-free community-based cohort. Methods - The CABL study (Cardiovascular Abnormalities and Brain Lesions) was designed to investigate cardiovascular predictors of silent cerebrovascular disease in the elderly. AAPs were assessed by suprasternal transthoracic echocardiography in 954 participants. Silent brain infarcts and white matter hyperintensity volume (WMHV) were assessed by brain magnetic resonance imaging. The association of AAP thickness with silent brain infarcts and WMHV was evaluated by logistic regression analysis. Results - Mean age was 71.6±9.3 years; 63% were women. AAP was present in 658 (69%) subjects. Silent brain infarcts were detected in 138 participants (14.5%). In multivariate analysis adjusted for potential confounders, AAP thickness and large AAP (≥4 mm in thickness) were significantly associated with the upper quartile of WMHV (WMHV-Q4;odds ratio =1.17;95% confidence interval, 1.04-1.32;P=0.009 and odds ratio =1.79;95% confidence interval, 1.40-3.09;P=0.036, respectively), but not with silent brain infarcts (odds ratio =1.08;95% confidence interval, 0.94-1.23;P=0.265 and odds ratio =1.46;95% confidence interval, 0.77-2.77;P=0.251, respectively). Conclusions - Aortic arch atherosclerosis was associated with WMHV in a stroke-free community-based elderly cohort. This association was stronger in subjects with large plaques and independent of cardiovascular risk factors. Aortic arch assessment by transthoracic echocardiography may help identify subjects at higher risk of subclinical cerebrovascular disease, who may benefit from aggressive stroke risk factors treatment.

Original languageEnglish (US)
Pages (from-to)2813-2819
Number of pages7
JournalStroke
Volume47
Issue number11
DOIs
StatePublished - Nov 1 2016

Fingerprint

Cerebrovascular Disorders
Atherosclerotic Plaques
Thoracic Aorta
Brain
Stroke
Odds Ratio
Confidence Intervals
Echocardiography
Cardiovascular Abnormalities
Atherosclerosis
Multivariate Analysis
Logistic Models
Regression Analysis
Magnetic Resonance Imaging
White Matter

Keywords

  • atherosclerosis
  • cerebrovascular diseases
  • silent brain infarct
  • stroke
  • white matter hyperintensity

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

Cite this

Tugcu, A., Jin, Z., Homma, S., Elkind, M. S. V., Rundek, T., Yoshita, M., ... Di Tullio, M. R. (2016). Atherosclerotic plaques in the aortic arch and subclinical cerebrovascular disease. Stroke, 47(11), 2813-2819. https://doi.org/10.1161/STROKEAHA.116.015002

Atherosclerotic plaques in the aortic arch and subclinical cerebrovascular disease. / Tugcu, Aylin; Jin, Zhezhen; Homma, Shunichi; Elkind, Mitchell S V; Rundek, Tatjana; Yoshita, Mitsuhiro; Decarli, Charles; Nakanishi, Koki; Shames, Sofia; Wright, Clinton B; Sacco, Ralph L; Di Tullio, Marco R.

In: Stroke, Vol. 47, No. 11, 01.11.2016, p. 2813-2819.

Research output: Contribution to journalArticle

Tugcu, A, Jin, Z, Homma, S, Elkind, MSV, Rundek, T, Yoshita, M, Decarli, C, Nakanishi, K, Shames, S, Wright, CB, Sacco, RL & Di Tullio, MR 2016, 'Atherosclerotic plaques in the aortic arch and subclinical cerebrovascular disease', Stroke, vol. 47, no. 11, pp. 2813-2819. https://doi.org/10.1161/STROKEAHA.116.015002
Tugcu, Aylin ; Jin, Zhezhen ; Homma, Shunichi ; Elkind, Mitchell S V ; Rundek, Tatjana ; Yoshita, Mitsuhiro ; Decarli, Charles ; Nakanishi, Koki ; Shames, Sofia ; Wright, Clinton B ; Sacco, Ralph L ; Di Tullio, Marco R. / Atherosclerotic plaques in the aortic arch and subclinical cerebrovascular disease. In: Stroke. 2016 ; Vol. 47, No. 11. pp. 2813-2819.
@article{18acb5984b1e44a289f00ac728ef0a8c,
title = "Atherosclerotic plaques in the aortic arch and subclinical cerebrovascular disease",
abstract = "Background and Purpose - Aortic arch plaque (AAP) is a risk factor for ischemic stroke, but its association with subclinical cerebrovascular disease is not established. We investigated the association between AAP and subclinical cerebrovascular disease in an elderly stroke-free community-based cohort. Methods - The CABL study (Cardiovascular Abnormalities and Brain Lesions) was designed to investigate cardiovascular predictors of silent cerebrovascular disease in the elderly. AAPs were assessed by suprasternal transthoracic echocardiography in 954 participants. Silent brain infarcts and white matter hyperintensity volume (WMHV) were assessed by brain magnetic resonance imaging. The association of AAP thickness with silent brain infarcts and WMHV was evaluated by logistic regression analysis. Results - Mean age was 71.6±9.3 years; 63{\%} were women. AAP was present in 658 (69{\%}) subjects. Silent brain infarcts were detected in 138 participants (14.5{\%}). In multivariate analysis adjusted for potential confounders, AAP thickness and large AAP (≥4 mm in thickness) were significantly associated with the upper quartile of WMHV (WMHV-Q4;odds ratio =1.17;95{\%} confidence interval, 1.04-1.32;P=0.009 and odds ratio =1.79;95{\%} confidence interval, 1.40-3.09;P=0.036, respectively), but not with silent brain infarcts (odds ratio =1.08;95{\%} confidence interval, 0.94-1.23;P=0.265 and odds ratio =1.46;95{\%} confidence interval, 0.77-2.77;P=0.251, respectively). Conclusions - Aortic arch atherosclerosis was associated with WMHV in a stroke-free community-based elderly cohort. This association was stronger in subjects with large plaques and independent of cardiovascular risk factors. Aortic arch assessment by transthoracic echocardiography may help identify subjects at higher risk of subclinical cerebrovascular disease, who may benefit from aggressive stroke risk factors treatment.",
keywords = "atherosclerosis, cerebrovascular diseases, silent brain infarct, stroke, white matter hyperintensity",
author = "Aylin Tugcu and Zhezhen Jin and Shunichi Homma and Elkind, {Mitchell S V} and Tatjana Rundek and Mitsuhiro Yoshita and Charles Decarli and Koki Nakanishi and Sofia Shames and Wright, {Clinton B} and Sacco, {Ralph L} and {Di Tullio}, {Marco R.}",
year = "2016",
month = "11",
day = "1",
doi = "10.1161/STROKEAHA.116.015002",
language = "English (US)",
volume = "47",
pages = "2813--2819",
journal = "Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "11",

}

TY - JOUR

T1 - Atherosclerotic plaques in the aortic arch and subclinical cerebrovascular disease

AU - Tugcu, Aylin

AU - Jin, Zhezhen

AU - Homma, Shunichi

AU - Elkind, Mitchell S V

AU - Rundek, Tatjana

AU - Yoshita, Mitsuhiro

AU - Decarli, Charles

AU - Nakanishi, Koki

AU - Shames, Sofia

AU - Wright, Clinton B

AU - Sacco, Ralph L

AU - Di Tullio, Marco R.

PY - 2016/11/1

Y1 - 2016/11/1

N2 - Background and Purpose - Aortic arch plaque (AAP) is a risk factor for ischemic stroke, but its association with subclinical cerebrovascular disease is not established. We investigated the association between AAP and subclinical cerebrovascular disease in an elderly stroke-free community-based cohort. Methods - The CABL study (Cardiovascular Abnormalities and Brain Lesions) was designed to investigate cardiovascular predictors of silent cerebrovascular disease in the elderly. AAPs were assessed by suprasternal transthoracic echocardiography in 954 participants. Silent brain infarcts and white matter hyperintensity volume (WMHV) were assessed by brain magnetic resonance imaging. The association of AAP thickness with silent brain infarcts and WMHV was evaluated by logistic regression analysis. Results - Mean age was 71.6±9.3 years; 63% were women. AAP was present in 658 (69%) subjects. Silent brain infarcts were detected in 138 participants (14.5%). In multivariate analysis adjusted for potential confounders, AAP thickness and large AAP (≥4 mm in thickness) were significantly associated with the upper quartile of WMHV (WMHV-Q4;odds ratio =1.17;95% confidence interval, 1.04-1.32;P=0.009 and odds ratio =1.79;95% confidence interval, 1.40-3.09;P=0.036, respectively), but not with silent brain infarcts (odds ratio =1.08;95% confidence interval, 0.94-1.23;P=0.265 and odds ratio =1.46;95% confidence interval, 0.77-2.77;P=0.251, respectively). Conclusions - Aortic arch atherosclerosis was associated with WMHV in a stroke-free community-based elderly cohort. This association was stronger in subjects with large plaques and independent of cardiovascular risk factors. Aortic arch assessment by transthoracic echocardiography may help identify subjects at higher risk of subclinical cerebrovascular disease, who may benefit from aggressive stroke risk factors treatment.

AB - Background and Purpose - Aortic arch plaque (AAP) is a risk factor for ischemic stroke, but its association with subclinical cerebrovascular disease is not established. We investigated the association between AAP and subclinical cerebrovascular disease in an elderly stroke-free community-based cohort. Methods - The CABL study (Cardiovascular Abnormalities and Brain Lesions) was designed to investigate cardiovascular predictors of silent cerebrovascular disease in the elderly. AAPs were assessed by suprasternal transthoracic echocardiography in 954 participants. Silent brain infarcts and white matter hyperintensity volume (WMHV) were assessed by brain magnetic resonance imaging. The association of AAP thickness with silent brain infarcts and WMHV was evaluated by logistic regression analysis. Results - Mean age was 71.6±9.3 years; 63% were women. AAP was present in 658 (69%) subjects. Silent brain infarcts were detected in 138 participants (14.5%). In multivariate analysis adjusted for potential confounders, AAP thickness and large AAP (≥4 mm in thickness) were significantly associated with the upper quartile of WMHV (WMHV-Q4;odds ratio =1.17;95% confidence interval, 1.04-1.32;P=0.009 and odds ratio =1.79;95% confidence interval, 1.40-3.09;P=0.036, respectively), but not with silent brain infarcts (odds ratio =1.08;95% confidence interval, 0.94-1.23;P=0.265 and odds ratio =1.46;95% confidence interval, 0.77-2.77;P=0.251, respectively). Conclusions - Aortic arch atherosclerosis was associated with WMHV in a stroke-free community-based elderly cohort. This association was stronger in subjects with large plaques and independent of cardiovascular risk factors. Aortic arch assessment by transthoracic echocardiography may help identify subjects at higher risk of subclinical cerebrovascular disease, who may benefit from aggressive stroke risk factors treatment.

KW - atherosclerosis

KW - cerebrovascular diseases

KW - silent brain infarct

KW - stroke

KW - white matter hyperintensity

UR - http://www.scopus.com/inward/record.url?scp=84992679398&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84992679398&partnerID=8YFLogxK

U2 - 10.1161/STROKEAHA.116.015002

DO - 10.1161/STROKEAHA.116.015002

M3 - Article

VL - 47

SP - 2813

EP - 2819

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 11

ER -