1015-75 Detection of Aortic Plaques is not Predictive of Coronary Artery Disease In the Elderly: A Biplane Transesophageal Echocardiographic Study

Abstract

Atherosclerotic aortic plaques detected by transesophageal echocardiography (TEE) have been reported to be a marker for coronary artery disease (CAD). Its significance may particularly be important in elderly population, though there are no data yet available. To elucidate the significance of aortic plaques in the elderly, we performed TEE on 84 patients (pts) (44 men, 40 women, age 61 ± 11 years) who had previously undergone coronary arteriography. (1) Significant CAD (≥ 75% stenosis) was detected in at least one major coronary artery in 26 of the 84 pts. Aortic plaques were detected by TEE in 24 of the 26 pts with CAD (92%) and in 32 of 58 pts without CAD (55%) (p < 0.01). (2) In pts aged 70 years (n = 25), aortic plaques were present in 13 of 14 pts with CAD (93%) and 10 of 11 pts without CAD (91%) (p = ns). In pts aged < 70 years (n = 59), aortic plaques were present in 10 of 12 pts with CAD (83%) and 22 of 47 pts without CAD (47%) (p = 0.02). (3) The independent association between CAD and age, the presence of aortic plaques on TEE and other coronary risk factors was examined by multiple regression analysis. In pts aged ≥ 70 years, the presence of aortic plaques on TEE failed to be a predictor of significant CAD, although it was indeed a strong predictor of CAD in pts aged ≥ 70 years (p < 0.01). In elderly pts, atherosclerotic aortic plaque detected by transesophageal echocardiography is not useful in predicting significant coronary artery disease. It is useful only in a relatively younger population.