Short-term evolution (9 months) of aortic atheroma in patients with or without embolic events: a follow-up transoesophageal echocardiographic study

Abstract

The influence of clinical risk factors and therapeutic options on aortic plaque changes is unknown. In this study, we have evaluated aortic atheroma (AA) evolution in patients with and without embolic events. We enrolled 83 patients (mean age 67.9+/-8.6 years). All patients were studied with transoesophageal echocardiography at baseline and 9 months after enrolment. Baseline atherosclerotic plaques were defined as uncomplicated (between 1 and 3.9 mm) and complicated aortic plaques (>or=4 mm). To minimize sub-millimetre errors in plaque evolution, AA progression was defined as an increase in maximal plaque thickness>or=1 mm. Similarly, regression was defined as a decrease in maximal thickness of atheromatous plaque>or=1 mm. Aortic plaques were classified as uncomplicated in 20.5% and complicated in 79.5% of patients. Fifty-five plaques (47.8%), both complicated and uncomplicated, remained unchanged. Conversely, 16 plaques (13.9%) increased (mean plaque thickness from 3.94+/-1.39 to 5.56+/-1.41 mm, P<0.001) and 44 (38.3%) decreased (mean plaque thickness from 5.25+/-1.52 to 3.79+/-1.53 mm, P<0.001). Multinomial logistic regression procedure suggests that statins increase the probability of plaque thickness reduction (OR 5.92, 95% CI 1.27-27.7, P=0.024) and decrease the probability of plaque progression (OR 0.03, 95% CI 0.01-0.28, P=0.002). This study suggests that statins may reduce the risk of AA progression.