Ultrasonographic frequency of complex aortic plaques in patients with atrial fibrillation

BACKGROUND: The presence of aortic plaque is an important risk factor for stroke in patients with atrial fibrillation (AF). A history of vascular disease, defined as the presence of complex aortic plaque (CAP), constitutes one of the components of the CHA₂DS₂-VA score. However, data regarding the frequency of abdominal aortic (AA) plaques in patients with AF are limited in the literature. Therefore, the present study aimed to investigate the prevalence of AA-CAP and its associated parameters in patients with AF. METHOD: A total of 748-patients with AF who underwent abdominal ultrasonography (US) for aortic plaque assessment were included in this study. In addition to routine clinical evaluations, all patients were assessed for the presence of AA-CAP using US. The study population was subsequently divided into two groups according to the presence or absence of AA-CAP. RESULT: AA-CAP was detected in 106 (14.2%) of the AF patients included in the study. Patients with AA-CAP were older and had higher CHA₂DS₂-VA scores and a greater burden of cardiovascular risk factors. In addition, blood pressure levels and glucose, urea, and creatinine values were higher, whereas hemoglobin levels were lower in patients with AA-CAP. In logistic regression analysis, age, CHA₂DS₂-VA score, and the presence of hypertension were found to be independently associated with AA-CAP (OR = 1.071,95%CI:1.031-1.111,p < 0.001;OR = 2.446,95%CI:1.900-3.149,p < 0.001;OR = 2.735,95%CI:1.441-5.190,p = 0.002). ROC curve analysis demonstrated that age and CHA₂DS₂-VA score, with cut-off values of 65 years and 3, respectively, identified the presence of AA-CAP with acceptable sensitivity and specificity. CONCLUSION: AA-CAP was observed at a considerable rate (14.2%) in patients with AF. Therefore, in AF patients without previously known coronary or peripheral arterial disease, assessment of AA-CAP using abdominal US may be useful for stroke risk stratification and for more accurate calculation of the CHA₂DS₂-VA score.