Ateromatosis de la aorta torácica: su valor como predictora de mortalidad cardiovascular y eventos vasculares cerebrales y coronarios / Atheromatosis of the Thoracic Aorta: as Predictor of Cardiovascular Mortality and Cerebrovascular and Coronary Events
Rev. argent. cardiol
; 79(3): 231-237, jun. 2011. ilus, tab
Article
in Es
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| ID: lil-634269
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RESUMEN
Objetivo Evaluar la gravedad de la ateromatosis de la aorta torácica y su relación con la mortalidad y los eventos vasculares cerebrales y coronarios. Material y métodos Entre 2005 y 2007 ingresaron prospectivamente 601 pacientes (p) enviados para ecocardiograma transesofágico (ETE). Edad 64,53±13,61 años. Sexo masculino 337 p. Se registró Motivo del estudio foco embolígeno (37,7%), endocarditis (22,1%), precardioversión (11,5%), valvulopatía mitral (9,8%), otros (18,95%). Factores de riesgo diabetes, tabaquismo, hipertensión arterial, dislipemia. Presencia de fibrilación auricular. Los p fueron agrupados en a. Con placas aórticas <4 mm y no complicadas p = 465. b. Con placas ≥ 4 mm y/o ulceradas, con trombos o debris (ateromatosis aórtica compleja [AAC]) p = 136. Seguimiento 1596 días (media 759 días). Se contactaron 520 p (86,52%), considerándose los siguientes eventos accidente cerebrovascular transitorio o permanente, IAM, angina, revascularización y/o causa de muerte en dicho período. Se utilizó el análisis multivariado para hallar predictores independientes. Se consideró significativa un p < de 0,01. Resultados Mortalidad cardiovascular 3,2% (13/407 p) en el grupo a y 18,6% (21/113 p) en el grupo b (p < 0,01). Eventos vasculares combinados 91/407 p (22,4%) en el grupo a y 45/113 p (39,8%) en el grupo b (p < 0,01). En el análisis multivariado, la AAC fue predictora independiente de mortalidad cardiovascular (OR 4,54, 95% IC 1,52-13,58 p < 0,01) y de eventos vasculares cerebrales y/o coronarios (OR 3,33, 95% IC 1,66-6,67 p < 0,01). Conclusión En esta población, la AAC fue predictora independiente de mortalidad cardiovascular y de eventos vasculares combinados.
ABSTRACT
Objective To evaluate the severity of atheromatosis of the thoracic aorta and its relation with mortality and cerebrovascular and coronary events. Material and Methods Between 2005 and 2007, 601 patients (ps) were referred for evaluation with transesophageal echocardiography (TEE). Age 64.53±13.61 years Male gender 337ps. The following variables were included Reason for ordering the study embolic source (37.7%), endocarditis (22.1%), previous to cardioversion (11.5%), mitral valve disease (9.8%), other reasons (18.95%). Risk factors diabetes, smoking habits, hypertension, dyslipidemia. Presence of atrial fibrillation. The patients were divided into two groups With uncomplicated aortic plaques < 4 mm ps = 465. With complex aortic atheromatosis (CAA) aortic plaques ≥ 4 mm, with ulcers, thrombi or aortic debris ps = 136. Follow-up 1596 days (mean 759 days). A total of 520 ps (86.52%) were contacted; the following events were considered transient ischemic attack or stroke, AMI, angina, revascularization and/or cause of mortality during that period. Multivariate analysis was used to identify independent predictors. A p value < 0.01 was considered statistically significant. Results Cardiovascular mortality 3.2% (13/407 ps) in group a and 18.6% (21/113 ps) in group b (p<0.01). Combined vascular events 91/407 ps (22.4%) in group a and 45/113 ps (39.8%) in group b (p<0.01). Multivariate analysis showed that CAA was an independent predictor of cardiovascular mortality (OR 4.54, 95% CI 1.52-13.58, p<0.01) and of cerebrovascular and/or coronary events (OR 3.33, 95% CI 1.66-6.67, p<0.01). Conclusions In this population, CAA was an independent predictor of cardiovascular mortality and combined vascular events.
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Index:
LILACS
Type of study:
Prognostic_studies
/
Risk_factors_studies
Language:
Es
Journal:
Rev. argent. cardiol
Journal subject:
CARDIOLOGIA
/
Doenas Cardiovasculares
Year:
2011
Type:
Article