From the Guidelines
A person with atherosclerosis of the thoracic aorta can live for many years with proper management, and their life expectancy varies widely depending on disease severity, but with aggressive risk factor modification and regular monitoring, many patients can live a normal or near-normal lifespan. The management of this condition typically includes medications such as statins (like atorvastatin 20-80mg daily or rosuvastatin 10-40mg daily) to lower cholesterol, as recommended by the 2022 ACC/AHA guideline for the diagnosis and management of aortic disease 1. Antihypertensives to control blood pressure (such as ACE inhibitors, ARBs, or beta-blockers), and antiplatelet therapy (aspirin 81mg daily) are also crucial. Lifestyle modifications are essential and include:
- Smoking cessation
- Regular exercise (30 minutes of moderate activity most days)
- Maintaining a healthy weight
- Following a heart-healthy diet low in saturated fats and sodium Regular monitoring with imaging studies every 6-12 months is important to track disease progression, as the average rate of expansion of thoracic aortic aneurysms is estimated to be 0.10 to 0.42 cm/y 1. The condition can be stable for many years with proper management, but complications like aneurysm formation or dissection can significantly impact survival. Early detection and aggressive risk factor modification are key to improving long-term outcomes, as they can slow disease progression and prevent life-threatening complications, with statin therapy showing a possible benefit in reducing aortic growth rate and complications 1.
From the Research
Atherosclerosis of the Thoracic Aorta
- Atherosclerosis of the thoracic aorta is a condition where the aorta, the main artery that carries blood from the heart to the rest of the body, becomes narrowed and hardened due to the buildup of plaque 2.
- This condition can increase the risk of embolic events, such as stroke, transient ischemic attack, and peripheral emboli 2, 3.
- The severity of atherosclerosis in the thoracic aorta can be assessed using transesophageal echocardiography (TEE), which can help identify protruding aortic plaques and mobile thrombi 2, 4.
Prognosis and Life Expectancy
- The life expectancy of a person with atherosclerosis of the thoracic aorta depends on various factors, including the severity of the condition, the presence of other health problems, and the effectiveness of treatment 5, 6.
- Studies have shown that patients with severe atherosclerosis of the thoracic aorta are at higher risk of embolic events and may require more aggressive treatment, such as anticoagulation therapy or surgery 2, 3.
- However, there is limited data available on the long-term prognosis and life expectancy of patients with atherosclerosis of the thoracic aorta, and more research is needed to fully understand the implications of this condition 5, 6.
Risk Factors and Associations
- Atherosclerosis of the thoracic aorta is often associated with other cardiovascular risk factors, such as hypertension, hypercholesterolemia, and smoking 5, 6.
- The presence of atherosclerosis in the descending thoracic aorta has been shown to be independently associated with coronary artery disease (CAD) on multi-detector row computed tomography coronary angiography 6.
- Patients with severe aortic stenosis and coexisting coronary artery disease have been found to have more extensive arteriosclerotic changes in the thoracic aorta compared to those with aortic stenosis alone or control subjects 5.