Atherosclerosis of the aorta: Risk factor, risk marker, or innocent bystander?: A prospective population-based transesophageal echocardiography study

Irene Meissner, Bijoy K. Khandheria, Sheldon G. Sheps, Gary Lee Schwartz, David O. Wiebers, Jack P. Whisnant, Jody L. Covalt, Tanya M. Petterson, Teresa J H Christianson, Yoram Agmon

Research output: Contribution to journalArticle

105 Citations (Scopus)

Abstract

The goal of this study was to investigate whether complex aortic atherosclerosis is associated with increased risk of vascular events in a non-selected population. In selected high-risk patients, aortic atherosclerosis is associated with increased risk of vascular events. We describe the relationship between simple versus complex (>4-mm thick or mobile debris) aortic atherosclerotic plaques and vascular events during follow-up in a random sample of 585 persons (age ≥45 years) using 1993 to 2000 data from the Stroke Prevention: Assessment of Risk in a Community (SPARC), a prospective population-based longitudinal study. At five-year median follow-up (range, 0.5 to 6.5 years), cardiac events (death, non-fatal myocardial infarction, coronary revascularization, heart failure associated with coronary artery disease) and cerebrovascular events (ischemic fatal and non-fatal strokes, transient ischemic attacks) had occurred in 95 subjects and 41 subjects, respectively. Age, male gender, prior coronary artery disease, higher pulse pressure, and diabetes were significant cardiovascular predictors. Age, prior myocardial infarction, and a history of atrial fibrillation were significant cerebrovascular predictors. Simple aortic plaques (253 persons) were not independently associated with either cardiac or cerebrovascular events. Complex plaques (44 persons) were marginally associated with cardiac events, adjusting for age and gender (hazard ratio [HR], 2.28; 95% confidence interval [CI], 1.11 to 4.68; p = 0.053 for two degrees of freedom [complex and simple plaques vs. no plaques]) but not after adjusting for additional clinical risk factors (HR, 1.22; 95% CI, 0.57 to 2.62; p = 0.64). Complex plaques were associated with cerebrovascular events only univariately. Aortic atherosclerotic plaques are not associated with future cardiac or cerebrovascular events. Aortic atherosclerosis may not be an independent risk factor for vascular events in the general population.

Original languageEnglish (US)
Pages (from-to)1018-1024
Number of pages7
JournalJournal of the American College of Cardiology
Volume44
Issue number5
DOIs
StatePublished - Sep 1 2004

Fingerprint

Transesophageal Echocardiography
Blood Vessels
Aorta
Atherosclerosis
Atherosclerotic Plaques
Population
Coronary Artery Disease
Stroke
Myocardial Infarction
Confidence Intervals
Transient Ischemic Attack
Atrial Fibrillation
Longitudinal Studies
Heart Failure
Blood Pressure

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Atherosclerosis of the aorta : Risk factor, risk marker, or innocent bystander?: A prospective population-based transesophageal echocardiography study. / Meissner, Irene; Khandheria, Bijoy K.; Sheps, Sheldon G.; Schwartz, Gary Lee; Wiebers, David O.; Whisnant, Jack P.; Covalt, Jody L.; Petterson, Tanya M.; Christianson, Teresa J H; Agmon, Yoram.

In: Journal of the American College of Cardiology, Vol. 44, No. 5, 01.09.2004, p. 1018-1024.

Research output: Contribution to journalArticle

Meissner, Irene ; Khandheria, Bijoy K. ; Sheps, Sheldon G. ; Schwartz, Gary Lee ; Wiebers, David O. ; Whisnant, Jack P. ; Covalt, Jody L. ; Petterson, Tanya M. ; Christianson, Teresa J H ; Agmon, Yoram. / Atherosclerosis of the aorta : Risk factor, risk marker, or innocent bystander?: A prospective population-based transesophageal echocardiography study. In: Journal of the American College of Cardiology. 2004 ; Vol. 44, No. 5. pp. 1018-1024.
@article{5c16a31317f346cb867d7ca015373c32,
title = "Atherosclerosis of the aorta: Risk factor, risk marker, or innocent bystander?: A prospective population-based transesophageal echocardiography study",
abstract = "The goal of this study was to investigate whether complex aortic atherosclerosis is associated with increased risk of vascular events in a non-selected population. In selected high-risk patients, aortic atherosclerosis is associated with increased risk of vascular events. We describe the relationship between simple versus complex (>4-mm thick or mobile debris) aortic atherosclerotic plaques and vascular events during follow-up in a random sample of 585 persons (age ≥45 years) using 1993 to 2000 data from the Stroke Prevention: Assessment of Risk in a Community (SPARC), a prospective population-based longitudinal study. At five-year median follow-up (range, 0.5 to 6.5 years), cardiac events (death, non-fatal myocardial infarction, coronary revascularization, heart failure associated with coronary artery disease) and cerebrovascular events (ischemic fatal and non-fatal strokes, transient ischemic attacks) had occurred in 95 subjects and 41 subjects, respectively. Age, male gender, prior coronary artery disease, higher pulse pressure, and diabetes were significant cardiovascular predictors. Age, prior myocardial infarction, and a history of atrial fibrillation were significant cerebrovascular predictors. Simple aortic plaques (253 persons) were not independently associated with either cardiac or cerebrovascular events. Complex plaques (44 persons) were marginally associated with cardiac events, adjusting for age and gender (hazard ratio [HR], 2.28; 95{\%} confidence interval [CI], 1.11 to 4.68; p = 0.053 for two degrees of freedom [complex and simple plaques vs. no plaques]) but not after adjusting for additional clinical risk factors (HR, 1.22; 95{\%} CI, 0.57 to 2.62; p = 0.64). Complex plaques were associated with cerebrovascular events only univariately. Aortic atherosclerotic plaques are not associated with future cardiac or cerebrovascular events. Aortic atherosclerosis may not be an independent risk factor for vascular events in the general population.",
author = "Irene Meissner and Khandheria, {Bijoy K.} and Sheps, {Sheldon G.} and Schwartz, {Gary Lee} and Wiebers, {David O.} and Whisnant, {Jack P.} and Covalt, {Jody L.} and Petterson, {Tanya M.} and Christianson, {Teresa J H} and Yoram Agmon",
year = "2004",
month = "9",
day = "1",
doi = "10.1016/j.jacc.2004.05.075",
language = "English (US)",
volume = "44",
pages = "1018--1024",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "5",

}

TY - JOUR

T1 - Atherosclerosis of the aorta

T2 - Risk factor, risk marker, or innocent bystander?: A prospective population-based transesophageal echocardiography study

AU - Meissner, Irene

AU - Khandheria, Bijoy K.

AU - Sheps, Sheldon G.

AU - Schwartz, Gary Lee

AU - Wiebers, David O.

AU - Whisnant, Jack P.

AU - Covalt, Jody L.

AU - Petterson, Tanya M.

AU - Christianson, Teresa J H

AU - Agmon, Yoram

PY - 2004/9/1

Y1 - 2004/9/1

N2 - The goal of this study was to investigate whether complex aortic atherosclerosis is associated with increased risk of vascular events in a non-selected population. In selected high-risk patients, aortic atherosclerosis is associated with increased risk of vascular events. We describe the relationship between simple versus complex (>4-mm thick or mobile debris) aortic atherosclerotic plaques and vascular events during follow-up in a random sample of 585 persons (age ≥45 years) using 1993 to 2000 data from the Stroke Prevention: Assessment of Risk in a Community (SPARC), a prospective population-based longitudinal study. At five-year median follow-up (range, 0.5 to 6.5 years), cardiac events (death, non-fatal myocardial infarction, coronary revascularization, heart failure associated with coronary artery disease) and cerebrovascular events (ischemic fatal and non-fatal strokes, transient ischemic attacks) had occurred in 95 subjects and 41 subjects, respectively. Age, male gender, prior coronary artery disease, higher pulse pressure, and diabetes were significant cardiovascular predictors. Age, prior myocardial infarction, and a history of atrial fibrillation were significant cerebrovascular predictors. Simple aortic plaques (253 persons) were not independently associated with either cardiac or cerebrovascular events. Complex plaques (44 persons) were marginally associated with cardiac events, adjusting for age and gender (hazard ratio [HR], 2.28; 95% confidence interval [CI], 1.11 to 4.68; p = 0.053 for two degrees of freedom [complex and simple plaques vs. no plaques]) but not after adjusting for additional clinical risk factors (HR, 1.22; 95% CI, 0.57 to 2.62; p = 0.64). Complex plaques were associated with cerebrovascular events only univariately. Aortic atherosclerotic plaques are not associated with future cardiac or cerebrovascular events. Aortic atherosclerosis may not be an independent risk factor for vascular events in the general population.

AB - The goal of this study was to investigate whether complex aortic atherosclerosis is associated with increased risk of vascular events in a non-selected population. In selected high-risk patients, aortic atherosclerosis is associated with increased risk of vascular events. We describe the relationship between simple versus complex (>4-mm thick or mobile debris) aortic atherosclerotic plaques and vascular events during follow-up in a random sample of 585 persons (age ≥45 years) using 1993 to 2000 data from the Stroke Prevention: Assessment of Risk in a Community (SPARC), a prospective population-based longitudinal study. At five-year median follow-up (range, 0.5 to 6.5 years), cardiac events (death, non-fatal myocardial infarction, coronary revascularization, heart failure associated with coronary artery disease) and cerebrovascular events (ischemic fatal and non-fatal strokes, transient ischemic attacks) had occurred in 95 subjects and 41 subjects, respectively. Age, male gender, prior coronary artery disease, higher pulse pressure, and diabetes were significant cardiovascular predictors. Age, prior myocardial infarction, and a history of atrial fibrillation were significant cerebrovascular predictors. Simple aortic plaques (253 persons) were not independently associated with either cardiac or cerebrovascular events. Complex plaques (44 persons) were marginally associated with cardiac events, adjusting for age and gender (hazard ratio [HR], 2.28; 95% confidence interval [CI], 1.11 to 4.68; p = 0.053 for two degrees of freedom [complex and simple plaques vs. no plaques]) but not after adjusting for additional clinical risk factors (HR, 1.22; 95% CI, 0.57 to 2.62; p = 0.64). Complex plaques were associated with cerebrovascular events only univariately. Aortic atherosclerotic plaques are not associated with future cardiac or cerebrovascular events. Aortic atherosclerosis may not be an independent risk factor for vascular events in the general population.

UR - http://www.scopus.com/inward/record.url?scp=4444301915&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=4444301915&partnerID=8YFLogxK

U2 - 10.1016/j.jacc.2004.05.075

DO - 10.1016/j.jacc.2004.05.075

M3 - Article

C2 - 15337213

AN - SCOPUS:4444301915

VL - 44

SP - 1018

EP - 1024

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 5

ER -