Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2026
Carotid plaque characteristics and their association with cardiovascular risk factors and coronary atherosclerosis in a middle-aged population.
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Good Elin, Soto Oscar, Bilos Linda, Ahlström Håkan, Bianchessi Tamara, Engvall Jan, Gonçalves Isabel, Troung My, Hjelmgren Ola, Marlevi David, Wegmann Bertil, Dyverfeldt Petter
Аннотация
BACKGROUND: Carotid and coronary atherosclerosis are critical determinants of cardiovascular risk, yet their interrelationship in middle-aged populations is incompletely understood. This study assessed carotid plaque composition, risk-factor associations, coronary disease, and sex differences in a subclinical cohort.
METHODS: Within the Swedish CArdioPulmonary bioImage Study, 533 asymptomatic individuals aged 50-64 years with carotid plaque ≥2.7 mm on ultrasound underwent 3T multi-contrast carotid cardiovascular magnetic resonance (CMR) and coronary computed tomography angiography. Carotid plaque characteristics were determined manually using established criteria on multi-contrast weighted carotid CMR. Bayesian regression models evaluated associations between cardiovascular risk factors and coronary atherosclerosis.
RESULTS: Lipid-rich necrotic core (LRNC) was present in 60% (320/533) and intraplaque hemorrhage (IPH) in 5.4% (29/533); calcification occurred in 48.6% (259/533). Maximum carotid wall thickness was 1.8 (1.6-2.0) mm, and mean lumen area 31.3 (26.7-36.1) mm². Coronary atherosclerosis was present in 63.6% (339/533) of participants, with ≥50% stenosis in 12.9% (69/533), and coronary artery calcium score >400 in 12.8% (68/533). Men (N = 367) had larger carotid lumen area, mean wall area, and maximum wall thickness (all p < 0.001) than women (N = 166), differences that persisted after body-surface-area adjustment (all p < 0.01). LRNC was present in 66% (242/367) of men compared to 47% (78/166) of women (p < 0.001). LRNC presence was not associated with coronary atherosclerosis, whereas IPH was associated with coronary involvement.
CONCLUSION: In middle-aged individuals, distinct cardiovascular risk factors were positively linked to the presence and volume of LRNC and calcified plaques. The substantial prevalence of high-risk plaque features, particularly LRNC and especially in men, highlights a significant subclinical carotid disease burden.
METHODS: Within the Swedish CArdioPulmonary bioImage Study, 533 asymptomatic individuals aged 50-64 years with carotid plaque ≥2.7 mm on ultrasound underwent 3T multi-contrast carotid cardiovascular magnetic resonance (CMR) and coronary computed tomography angiography. Carotid plaque characteristics were determined manually using established criteria on multi-contrast weighted carotid CMR. Bayesian regression models evaluated associations between cardiovascular risk factors and coronary atherosclerosis.
RESULTS: Lipid-rich necrotic core (LRNC) was present in 60% (320/533) and intraplaque hemorrhage (IPH) in 5.4% (29/533); calcification occurred in 48.6% (259/533). Maximum carotid wall thickness was 1.8 (1.6-2.0) mm, and mean lumen area 31.3 (26.7-36.1) mm². Coronary atherosclerosis was present in 63.6% (339/533) of participants, with ≥50% stenosis in 12.9% (69/533), and coronary artery calcium score >400 in 12.8% (68/533). Men (N = 367) had larger carotid lumen area, mean wall area, and maximum wall thickness (all p < 0.001) than women (N = 166), differences that persisted after body-surface-area adjustment (all p < 0.01). LRNC was present in 66% (242/367) of men compared to 47% (78/166) of women (p < 0.001). LRNC presence was not associated with coronary atherosclerosis, whereas IPH was associated with coronary involvement.
CONCLUSION: In middle-aged individuals, distinct cardiovascular risk factors were positively linked to the presence and volume of LRNC and calcified plaques. The substantial prevalence of high-risk plaque features, particularly LRNC and especially in men, highlights a significant subclinical carotid disease burden.
Предметные рубрики MeSH
HumansMaleMiddle AgedFemalePlaque, AtheroscleroticCoronary Artery DiseaseSwedenHeart Disease Risk FactorsPredictive Value of TestsCarotid Artery DiseasesUltrasonography, Carotid ArteriesSex FactorsComputed Tomography AngiographyCoronary AngiographyRisk AssessmentCarotid ArteriesNecrosisAsymptomatic DiseasesMagnetic Resonance AngiographyRisk FactorsPrognosisPrevalenceVascular CalcificationSeverity of Illness Index