Protruding atherosclerotic aortic plaques and dyslipidaemia: Correlation to subtypes of ischaemic stroke

Abstract

Aims: To evaluate whether thoracic aortic plaques together with dyslipidaemia are related to ischaemic stroke, and if so, to which of the subtypes of stroke. Methods and Results: We performed transoesophageal echocardiography in 50 patients with acute ischaemic stroke and in 401 controls. The aorta was divided into two segments: (1) the proximal, proximal to the left subclavian artery, and (2) the distal aorta. Protruding plaques (Intima ≥ 4 mm in thickness) in the proximal aorta were detected in 14 of the 50 patients (28%) with stroke, and in 53 of the 401 controls (13%) (P<0.01). Plaque score in the proximal aorta (2.1 ± 1.8 vs 0.9 ± 0.7; P<0.05), low-density lipoprotein cholesterol level (3.60 ± 0.85 vs 2.87 ± 0.72 mmol/l; P<0.05), and apolipoprotein B/A-I ratio (0.98 ± 0.17 vs 0.73 ± 0.16; P<0.005) were higher in patients with atherothrombotic than in cardioembolic stroke. The score in the proximal aorta correlated with low-density lipoprotein cholesterol level (r=0.44, P<0.005) and apolipoprotein B/A-I ratio (r=0.40, P<0.01). Conclusion: Severe plaques in the proximal aorta together with dyslipidaemia are seen more frequently in patients with atherothrombotic stroke. Lipid analysis may contribute to the prediction and the treatment of the patients who are at high risk for atherothrombotic stroke. © 2002 Published by Elsevier Science Ltd on behalf of The European Society of Cardiology.