Atherosclerosis of the thoracic aorta and aortic debris as a marker of poor prognosis: benefit of oral anticoagulants

Ferrari, Émile; Vidal, Renaud; Chevallier, Thierry; Baudouy, Marcel

doi:10.1016/s0735-1097(99)00003-0

Cited by 220 publications

(127 citation statements)

References 23 publications

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“…15 However, the proper therapy for this condition is unknown so far. In smaller, nonrandomized studies, oral anticoagulants were superior to aspirin, 20,21 whereas in a larger retrospective, nonrandomized analysis, only statins showed a significant benefit. 22 The ongoing Aortic arch Related Cerebral Hazard (ARCH) trial comparing clopidogrel plus aspirin versus warfarin will contribute substantial information for the optimal treatment and might increase the diagnostic impact of TEE.…”

Section: Clinical Implications Of Cardiac High-risk Sources In Teementioning

confidence: 95%

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Therapeutic Strategies After Examination by Transesophageal Echocardiography in 503 Patients With Ischemic Stroke

Harloff

Handke

Reinhard

et al. 2006

Stroke

127

109

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Section: Clinical Implications Of Cardiac High-risk Sources In Teementioning

confidence: 95%

“…19,20 However, there is no evidence based treatment for this situation so far. With disappearance of aortic thrombi in TEE control 4 weeks later, medication was changed to platelet inhibitors plus statins for plaque stabilization in our patients.…”

Section: Clinical Implications Of Cardiac High-risk Sources In Teementioning

confidence: 99%

Therapeutic Strategies After Examination by Transesophageal Echocardiography in 503 Patients With Ischemic Stroke

Harloff

Handke

Reinhard

et al. 2006

Stroke

127

109

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“…Earlier studies reported a potential benefit of anticoagulation. 30,31 On the other hand, Tunick et al 32 found no significant benefit of anticoagulant or antiplatelet drugs for patients with ACL. A large prospective study is needed to determine which of these are better for patients with ACL.…”

Section: Discussionmentioning

confidence: 99%

Predictors of aortic complicated lesions in stroke patients

et al. 2009

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Aortic complicated lesions (ACLs) should be associated with cerebral infarction. Our aim was to develop a simple clinical scale (ACL scale) to predict the presence of ACL. Consecutive stroke patients undergoing transesophageal echocardiogram (TEE) examination were prospectively enrolled. We defined ACL as the presence of 44 mm wall thickness, ulceration or mobile plaque in aortic arch. We also examined carotid intima-media thickness (IMT), ankle-brachial index (ABI) and brachial-ankle pulse-wave velocity (baPWV). We compared the clinical characteristics of patients with ACL (ACL group) and without ACL (non-ACL group), and devised a new ACL scale to predict the presence of ACL. In all, 165 patients (male 108, age 66.9 years) were enrolled and of these, 38% had ACL. The patients of the ACL group were older than those of the non-ACL group (73.0±10.2 vs. 63.1±13.6 years, P¼0.001). Peripheral artery disease (PAD) was more frequent in the ACL group (18 vs. 4%, P¼0.004). IMT was thicker in ACL group than in the non-ACL group (1.29 ± 0.74 vs. 1.11 ± 0.79 mm, P¼0.002), and baPWV was higher in the ACL group (2164.2 ± 643.2 vs. 1833.7 ± 492.9 cm s À1 , P¼0.001). We used three variables for determining the ACL scale score; (1) age 470, (2) presence of PAD and (3) smoking. The frequencies of ACL associated with ACL scale scores were as follows: 6% of patients with ACL scale score 0, 40% with score 1, 58% with score 2 and 100% with score 3. The ACL scale can predict the presence of aortic complicated lesions.

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“…Complex plaques more than 4mm in diameter, mobile or ulcerated are more likely to embolise and had higher recurrent stroke rate (23)(24)(25)(26)(27). Options of treatment are AC, the use of antiplatelet therapy or surgical resection (24,25,28). Current evidence favours the use of AC with surgery being considered in highly selected cases.…”

Section: Dilated Cardiomyopathymentioning

confidence: 99%

Risk factors for stroke and use of echocardiography in diagnosis: a review

Kinsara

2004

E Af Med Jrnl

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Background: Stroke is a prevalent disease in many communities. Cardiologists consultation and cardiac investigations are frequently requested to rule out cardiac source of embolic manifestations. The heart has been reported to account for 20% of ischaemic strokes in the Western community. Objective: To review risk factors for stroke and the use of echocardiography in its diagnosis. Methods: Medline review was done for reported causes of stroke, these causes were divided into major and minor and were discussed briefly as general physician need to determine when and what to ask for. Results: Some cardiac sources do have established roles in strokes but others have circumstantial and/or secondary roles. Conclusion: While there exists evidence to recommend echocardiogram in stroke patients with heart disease, it is routinely needed in all patients with stroke. In some circumstances, echocardiography may enhance the diagnosis but not necessarily change management.

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Atherosclerosis of the thoracic aorta and aortic debris as a marker of poor prognosis: benefit of oral anticoagulants

Abstract: We confirm the high incidence of vascular events and deaths in patients with AA. We have demonstrated, for the first time in this condition, a better outcome among patients treated with oral anticoagulants versus antiplatelets.

Cited by 220 publications

References 23 publications

Therapeutic Strategies After Examination by Transesophageal Echocardiography in 503 Patients With Ischemic Stroke

Therapeutic Strategies After Examination by Transesophageal Echocardiography in 503 Patients With Ischemic Stroke

Predictors of aortic complicated lesions in stroke patients

Risk factors for stroke and use of echocardiography in diagnosis: a review

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