Carotid atherosclerotic plaque predicts poor short-term outcomes of cerebral embolism due to non-valvular atrial fibrillation / 中华老年医学杂志

ABSTRACT

Objective To investigate the impact of carotid atherosclerotic plaque on short-term outcomes of cardioembolic stroke due to non-valvular atrial fibrillation (NVAF).Methods A total of 288 patients with acute cerebral embolism due to NVAF were recruited in this study.All patients underwent carotid ultrasonography screening to estimate carotid intima-medium thickness (IMT) and atherosclerotic plaque.The short-term outcomes were assessed.The correlation between carotid atherosclerotic plaque and short-term outcomes of cardioembolic stroke due to NVAF were determined by partial correlation analysis.Results Among the 288 patients,carotid atherosclerosis occurred in 202 cases (70.1％) of the patients,poor outcomes in 113 cases (39.1％),worsening neurological function in 43 cases(14.9％),and stroke recurrence in 24 cases(8.3％).Carotid atherosclerosis plaque was positively associated with neurological worsening (r =0.247,P =0.000) and poor outcomes (r=0.139,P=0.018).The use of aspirin was negatively correlated with both neurological worsening (r=-0.235,P=0.000) and recurrence of stroke (r=-0.177,P=0.003).The use of statin was negatively correlated with recurrence of stroke (r =-0.223,P =0.000),neurological worsening (r=-0.147,P=0.013) and poor outcomes (r=-0.286,P=0.000).Conclusions Carotid atherosclerotic plaque is an independent predictive factor for poor short-term outcomes of cardioembolic stroke due to NVAF,and the aggressive management for carotid plaque can improve the poor short-term outcomes.