Gender differences in the risk of ischemic stroke associated with aortic atheromas

Marco R. Di Tullio, Ralph L Sacco, Maria Teresa Savoia, Robert R. Sciacca, Shunichi Homma

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background and Purpose - Atherosclerotic plaque of the proximal portion of the aorta is associated with an increased risk of ischemic stroke in the elderly. Different cutoffs of plaque thickness have been used in the literature for risk stratification and have been applied to both men and women. However, the assumption that the relationship between plaque thickness and stroke risk is the same in the 2 genders has not been proven. The aim of this study was to evaluate whether the prevalence of different degrees of aortic plaque thickness differed in men and women with ischemic stroke. Methods - We performed transesophageal echocardiography in 152 patients aged >59 years with acute ischemic stroke (76 men and 76 women) and in 152 control subjects of similar age (70 men and 82 women). Odds ratios (ORs) for ischemic stroke with 95% CIs for different plaque thickness definitions were calculated for the overall group and separately for men and women by logistic regression analysis after adjusting for age, arterial hypertension, and hypercholesterolemia. Results - Aortic plaques ≥4 nun were significantly more frequent in men than in women (31.5% versus 20.3%, respectively; P=0.025) and were associated with ischemic stroke in both men (adjusted OR 6.0, CI 2.1 to 16.8) and women (adjusted OR 3.2, CI 1.2 to 8.8). However, plaques 3 to 3.9 mm in thickness had a significant association with stroke in women (adjusted OR 4.8, CI 1.7 to 15.0) but not in men (adjusted OR 0.8, CI 0.2 to 3.0). Plaques <3 mm were not associated with a significantly increased stroke risk for either sex. Conclusions - Smaller aortic plaques are significantly associated with ischemic stroke in women but not in men. If the increased prevalence of smaller plaques in women is confirmed to be associated with increased risk for embolic stroke, different cutoff points may have to be adopted in men and women for risk stratification and for decisions regarding medical intervention.

Original languageEnglish
Pages (from-to)2623-2627
Number of pages5
JournalStroke
Volume31
Issue number11
StatePublished - Nov 15 2000
Externally publishedYes

Fingerprint

Atherosclerotic Plaques
Stroke
Odds Ratio
Transesophageal Echocardiography
Hypercholesterolemia
Aorta
Logistic Models
Regression Analysis
Hypertension

Keywords

  • Aortic arch
  • Cerebrovascular disorders
  • Echocardiography, transesophageal
  • Stroke, ischemic

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Neuroscience(all)

Cite this

Di Tullio, M. R., Sacco, R. L., Savoia, M. T., Sciacca, R. R., & Homma, S. (2000). Gender differences in the risk of ischemic stroke associated with aortic atheromas. Stroke, 31(11), 2623-2627.

Gender differences in the risk of ischemic stroke associated with aortic atheromas. / Di Tullio, Marco R.; Sacco, Ralph L; Savoia, Maria Teresa; Sciacca, Robert R.; Homma, Shunichi.

In: Stroke, Vol. 31, No. 11, 15.11.2000, p. 2623-2627.

Research output: Contribution to journalArticle

Di Tullio, MR, Sacco, RL, Savoia, MT, Sciacca, RR & Homma, S 2000, 'Gender differences in the risk of ischemic stroke associated with aortic atheromas', Stroke, vol. 31, no. 11, pp. 2623-2627.
Di Tullio MR, Sacco RL, Savoia MT, Sciacca RR, Homma S. Gender differences in the risk of ischemic stroke associated with aortic atheromas. Stroke. 2000 Nov 15;31(11):2623-2627.
Di Tullio, Marco R. ; Sacco, Ralph L ; Savoia, Maria Teresa ; Sciacca, Robert R. ; Homma, Shunichi. / Gender differences in the risk of ischemic stroke associated with aortic atheromas. In: Stroke. 2000 ; Vol. 31, No. 11. pp. 2623-2627.
@article{4b3a9d41cc3f4a4a90103c6259483b8a,
title = "Gender differences in the risk of ischemic stroke associated with aortic atheromas",
abstract = "Background and Purpose - Atherosclerotic plaque of the proximal portion of the aorta is associated with an increased risk of ischemic stroke in the elderly. Different cutoffs of plaque thickness have been used in the literature for risk stratification and have been applied to both men and women. However, the assumption that the relationship between plaque thickness and stroke risk is the same in the 2 genders has not been proven. The aim of this study was to evaluate whether the prevalence of different degrees of aortic plaque thickness differed in men and women with ischemic stroke. Methods - We performed transesophageal echocardiography in 152 patients aged >59 years with acute ischemic stroke (76 men and 76 women) and in 152 control subjects of similar age (70 men and 82 women). Odds ratios (ORs) for ischemic stroke with 95{\%} CIs for different plaque thickness definitions were calculated for the overall group and separately for men and women by logistic regression analysis after adjusting for age, arterial hypertension, and hypercholesterolemia. Results - Aortic plaques ≥4 nun were significantly more frequent in men than in women (31.5{\%} versus 20.3{\%}, respectively; P=0.025) and were associated with ischemic stroke in both men (adjusted OR 6.0, CI 2.1 to 16.8) and women (adjusted OR 3.2, CI 1.2 to 8.8). However, plaques 3 to 3.9 mm in thickness had a significant association with stroke in women (adjusted OR 4.8, CI 1.7 to 15.0) but not in men (adjusted OR 0.8, CI 0.2 to 3.0). Plaques <3 mm were not associated with a significantly increased stroke risk for either sex. Conclusions - Smaller aortic plaques are significantly associated with ischemic stroke in women but not in men. If the increased prevalence of smaller plaques in women is confirmed to be associated with increased risk for embolic stroke, different cutoff points may have to be adopted in men and women for risk stratification and for decisions regarding medical intervention.",
keywords = "Aortic arch, Cerebrovascular disorders, Echocardiography, transesophageal, Stroke, ischemic",
author = "{Di Tullio}, {Marco R.} and Sacco, {Ralph L} and Savoia, {Maria Teresa} and Sciacca, {Robert R.} and Shunichi Homma",
year = "2000",
month = "11",
day = "15",
language = "English",
volume = "31",
pages = "2623--2627",
journal = "Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "11",

}

TY - JOUR

T1 - Gender differences in the risk of ischemic stroke associated with aortic atheromas

AU - Di Tullio, Marco R.

AU - Sacco, Ralph L

AU - Savoia, Maria Teresa

AU - Sciacca, Robert R.

AU - Homma, Shunichi

PY - 2000/11/15

Y1 - 2000/11/15

N2 - Background and Purpose - Atherosclerotic plaque of the proximal portion of the aorta is associated with an increased risk of ischemic stroke in the elderly. Different cutoffs of plaque thickness have been used in the literature for risk stratification and have been applied to both men and women. However, the assumption that the relationship between plaque thickness and stroke risk is the same in the 2 genders has not been proven. The aim of this study was to evaluate whether the prevalence of different degrees of aortic plaque thickness differed in men and women with ischemic stroke. Methods - We performed transesophageal echocardiography in 152 patients aged >59 years with acute ischemic stroke (76 men and 76 women) and in 152 control subjects of similar age (70 men and 82 women). Odds ratios (ORs) for ischemic stroke with 95% CIs for different plaque thickness definitions were calculated for the overall group and separately for men and women by logistic regression analysis after adjusting for age, arterial hypertension, and hypercholesterolemia. Results - Aortic plaques ≥4 nun were significantly more frequent in men than in women (31.5% versus 20.3%, respectively; P=0.025) and were associated with ischemic stroke in both men (adjusted OR 6.0, CI 2.1 to 16.8) and women (adjusted OR 3.2, CI 1.2 to 8.8). However, plaques 3 to 3.9 mm in thickness had a significant association with stroke in women (adjusted OR 4.8, CI 1.7 to 15.0) but not in men (adjusted OR 0.8, CI 0.2 to 3.0). Plaques <3 mm were not associated with a significantly increased stroke risk for either sex. Conclusions - Smaller aortic plaques are significantly associated with ischemic stroke in women but not in men. If the increased prevalence of smaller plaques in women is confirmed to be associated with increased risk for embolic stroke, different cutoff points may have to be adopted in men and women for risk stratification and for decisions regarding medical intervention.

AB - Background and Purpose - Atherosclerotic plaque of the proximal portion of the aorta is associated with an increased risk of ischemic stroke in the elderly. Different cutoffs of plaque thickness have been used in the literature for risk stratification and have been applied to both men and women. However, the assumption that the relationship between plaque thickness and stroke risk is the same in the 2 genders has not been proven. The aim of this study was to evaluate whether the prevalence of different degrees of aortic plaque thickness differed in men and women with ischemic stroke. Methods - We performed transesophageal echocardiography in 152 patients aged >59 years with acute ischemic stroke (76 men and 76 women) and in 152 control subjects of similar age (70 men and 82 women). Odds ratios (ORs) for ischemic stroke with 95% CIs for different plaque thickness definitions were calculated for the overall group and separately for men and women by logistic regression analysis after adjusting for age, arterial hypertension, and hypercholesterolemia. Results - Aortic plaques ≥4 nun were significantly more frequent in men than in women (31.5% versus 20.3%, respectively; P=0.025) and were associated with ischemic stroke in both men (adjusted OR 6.0, CI 2.1 to 16.8) and women (adjusted OR 3.2, CI 1.2 to 8.8). However, plaques 3 to 3.9 mm in thickness had a significant association with stroke in women (adjusted OR 4.8, CI 1.7 to 15.0) but not in men (adjusted OR 0.8, CI 0.2 to 3.0). Plaques <3 mm were not associated with a significantly increased stroke risk for either sex. Conclusions - Smaller aortic plaques are significantly associated with ischemic stroke in women but not in men. If the increased prevalence of smaller plaques in women is confirmed to be associated with increased risk for embolic stroke, different cutoff points may have to be adopted in men and women for risk stratification and for decisions regarding medical intervention.

KW - Aortic arch

KW - Cerebrovascular disorders

KW - Echocardiography, transesophageal

KW - Stroke, ischemic

UR - http://www.scopus.com/inward/record.url?scp=0033755474&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033755474&partnerID=8YFLogxK

M3 - Article

C2 - 11062285

AN - SCOPUS:0033755474

VL - 31

SP - 2623

EP - 2627

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 11

ER -