Impact of the Total Number of Carotid Plaques on the Outcome of Ischemic Stroke Patients with Atrial Fibrillation

• Published in: Journal of clinical medicine Vol. 8; no. 11; p. 1897
• Main Authors: Park, Hyungjong, Han, Minho, Kim, Young Dae, Yoo, Joonsang, Lee, Hye Sun, Choi, Jin Kyo, Heo, Ji Hoe, Nam, Hyo Suk
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI 07.11.2019; MDPI AG
• Subjects: atrial fibrillation; carotid stenosis; cerebral infarction; outcomes; ultrasonography; atrial fibrillation; carotid stenosis; cerebral infarction; outcomes; ultrasonography
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm8111897

Atrial fibrillation (AF) shares several risk factors with atherosclerosis. We investigated the association between total carotid plaque number (TPN) and long-term prognosis in ischemic stroke patients with AF. A total of 392 ischemic stroke patients with AF who underwent carotid ultrasonography were enrolled. TPN was assessed using B-mode ultrasound. The patients were categorized into two groups according to best cutoff values for TPN (TPN ≤ 4 vs. TPN ≥ 5). The long-term risk of major adverse cardiovascular events (MACE) and mortality according to TPN was investigated using a Cox hazard model. After a mean follow-up of 2.42 years, 113 patients (28.8%) had developed MACE and 88 patients (22.4%) had died. MACE occurred more frequently in the TPN ≥ 5 group than in the TPN ≤ 4 group (adjusted hazard ratio [HR], 1.50; 95% confidence interval [CI], 1.01-2.21; < 0.05). Moreover, the TPN ≥ 5 group showed an increased risk of all-cause mortality (adjusted HR, 2.69; 95% CI, 1.40-5.17; < 0.05). TPN along with maximal plaque thickness and intima media thickness showed improved prognostic utility when added to the variables of the CHAD DS -VASc score. TPN can predict the long-term outcome of ischemic stroke patients with AF. Adding TPN to the CHAD DS -VASc score increases the predictability of outcome after stroke.