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Open AccessArticle

Impact of the Total Number of Carotid Plaques on the Outcome of Ischemic Stroke Patients with Atrial Fibrillation

1
Department of Neurology, Yonsei University College of Medicine, Seoul 03722, Korea
2
Department of Neurology, Keimyung University School of Medicine, Daegu 42601, Korea
3
Biostatistics Collaboration Unit, Yonsei University College of Medicine, university, Seoul 03722, Korea
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(11), 1897; https://doi.org/10.3390/jcm8111897
Received: 10 September 2019 / Revised: 30 October 2019 / Accepted: 31 October 2019 / Published: 7 November 2019
(This article belongs to the Special Issue Diagnosis, Prevention and Treatment for Stroke)
Background: Atrial fibrillation (AF) shares several risk factors with atherosclerosis. We investigated the association between total carotid plaque number (TPN) and long-term prognosis in ischemic stroke patients with AF. Methods: A total of 392 ischemic stroke patients with AF who underwent carotid ultrasonography were enrolled. TPN was assessed using B-mode ultrasound. The patients were categorized into two groups according to best cutoff values for TPN (TPN ≤ 4 vs. TPN ≥ 5). The long-term risk of major adverse cardiovascular events (MACE) and mortality according to TPN was investigated using a Cox hazard model. Results: After a mean follow-up of 2.42 years, 113 patients (28.8%) had developed MACE and 88 patients (22.4%) had died. MACE occurred more frequently in the TPN ≥ 5 group than in the TPN ≤ 4 group (adjusted hazard ratio [HR], 1.50; 95% confidence interval [CI], 1.01–2.21; p < 0.05). Moreover, the TPN ≥ 5 group showed an increased risk of all-cause mortality (adjusted HR, 2.69; 95% CI, 1.40–5.17; p < 0.05). TPN along with maximal plaque thickness and intima media thickness showed improved prognostic utility when added to the variables of the CHAD2DS2-VASc score. Conclusion: TPN can predict the long-term outcome of ischemic stroke patients with AF. Adding TPN to the CHAD2DS2-VASc score increases the predictability of outcome after stroke. View Full-Text
Keywords: atrial fibrillation; cerebral infarction; carotid stenosis; ultrasonography; outcomes atrial fibrillation; cerebral infarction; carotid stenosis; ultrasonography; outcomes
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Park, H.; Han, M.; Kim, Y.D.; Yoo, J.; Lee, H.S.; Choi, J.K.; Heo, J.H.; Nam, H.S. Impact of the Total Number of Carotid Plaques on the Outcome of Ischemic Stroke Patients with Atrial Fibrillation. J. Clin. Med. 2019, 8, 1897.

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