St. Louis, April 1, 1999 -- Researchers have found that thickening of the aorta at the site where the vessel attaches to the heart can significantly increase the risk of stroke. Reporting in the April 1, 1999 issue of the Journal of the American College of Cardiology, investigators from Washington University School of Medicine in St. Louis, say atherosclerosis, or hardening, of the ascending aorta predicts future brain injury and death.
"This is the first prospective, long-term study of the relationship between atherosclerosis in the aorta and risk of stroke and death. We found that as this important vessel becomes diseased, long-term risk increases dramatically," says Victor G. Davila-Roman, M.D., principal investigator and associate professor of medicine and anesthesiology. "Now that we've identified patients at risk the next step is to identify treatments that can lower the risk."
Davila-Roman and colleagues studied 1,957 patients undergoing cardiac surgery. During the surgery, the researchers made images of the ascending aorta using a technique called epiaortic ultrasound. After evaluating those images to detect the presence and severity of atherosclerosis, they followed the study patients for an average of three and a half years.
Stroke is a major problem in patients undergoing cardiac surgery. Depending upon patient age and other risk factors, up to 15 percent have strokes during or soon after surgery. These investigators previously had shown that hardening of the aorta was a risk factor for those strokes. This new study wanted to learn whether the risk would decrease with time or remain high in patients with hardening of the aorta.
More than half of the patients in this study had no signs of atherosclerosis. About 24 percent had mild disease, while 13 percent were classified as moderate. The remaining 5 percent had severe atherosclerosis in the aorta.