Abstract Details

Title Atrial Cardiopathy and Large Aortic Arch Plaques in Patients with Embolic Stroke of Undetermined Source: Is There a Link?

Topic Cerebrovascular Disease and Interventional Neurology

Poster/Presentation
Number 133

Objective

To investigate the association between the presence of LAAP and AC in patients with ESUS.

Background

Approximately 25% of ischemic strokes are classified as embolic strokes of undetermined source (ESUS). Atrial cardiopathy(AC) and large aortic arch plaques (LAAP) are possible sources of embolism. However, the relationship between these two mechanisms remains unclear.

Design/Methods

Between January 2017 and Juin 2019, we prospectively identified patients hospitalized for acute ischemic stroke who met the ESUS diagnostic criteria.AC was defined as ≥ 1 of the following markers: P-wave terminal force >5000 µV × ms in ECG lead V₁, serum NT-proBNP > 250 pg/mL,left atrial diameter ≥4.5 cm on echocardiogram, the presence of supraventricular extrasystoles or newly diagnosed atrial fibrillation(AF) in ECG or on Holter monitoring performed during hospitalization or follow- up .The detection of LAAP (≥4 mm in thickness) was based on CT angiography of the supra-aortic vessels and transesophageal echocardiography performed in 100% and 10 % of participants respectively.

Results

Among 260 patients followed for 12 months, 60 (23,07%)ESUS patients( average age = 57,09 years old,66.6 % females) were included .Of 60 screened patients, 19 (31,66%) had AC, 8 (13,33%) had LAAP and only 3 (5%) patients had both. The overall rate of AF detection was 12,5% and 73,7% in patients with LAAP and AC respectively ( 95% confidence interval [CI] 0.47-0.95). The presence of LAAP was associated with lower probability for AF detection (adjusted HR 0.57, 95% CI 0.34-0.96, p < 0.05).
Shared risk factors for both potentiel embolic sources were increasing age, hypertension and coronary artery disease. Despite shared risk factors, the presence of AC was not associated with LAAP after adjustment for covariates (odds ratio [OR] : 1.06 [95% CI, 1.0-1.18] ; P=0.08).

Conclusions

We found no association between LAAP and AC in ESUS patients supporting the hypothesis of heterogeneous embolic sources.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
Mahouba Frih (University Hospital Fattouma Bourguiba Monastir)	MAHBOUBA FRIH has nothing to disclose.

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