Summary

In patients with cerebral ischemia, a frequent finding is atheromatousplaques in the ascending aorta and the aortic arch. Sincewe were able to demonstrate that patients with atrial fibrillationhave an increased coagulatory activity, we wanted to evaluate apotential systemic activation of the coagulatory system in patientswith aortic arch atheromatosis (Aortic AA). In 134 consecutivepatients, we determined several parameters of the coagulatoryand fibrinolytic systems as well as several thrombophiliarisk factors and compared the results with 134 age- and sexmatchedhealthy controls. In 90 of the 134 patients, transesophagealechocardiography showed Aortic AA, and in the remaining44 patients, there were no aortic findings. The Aortic AA group showed higher concentrations of thrombin-antithrombin(TAT) and plasmin-antiplasmin complexes (PAP). Further divisioninto 4 subgroups of different severity (grade I: no plaques;grade II:plaques 2–5 mm,grade III:plaques > 5 mm,grade IV:mobileplaques), revealed increasing concentrations of fibrinogen,D-dimers and tissue-type plasminogen activator. The grade IVgroupdisplayed the highest values in comparison to all othergroups. In conclusion,Aortic AA as such is a risk factor for cerebralischemia. It causes a systemically detectable activation ofcoagulation which substantially exceeds the values for controls.This observation is in accordance with our findings in patientswith atrial fibrillation.