A comparison of carotid atherosclerosis in symptomatic patients between 2002-2005 and 2012-2015 cohorts using multi-contrast magnetic resonance vessel wall imaging

摘要

OBJECTIVE To compare the morphological and compositional characteristics of carotid plaques in two cohorts(2002−2005 and 2012−2015)of Chinese patients using magnetic resonance vessel wall imaging.METHODS Symptomatic patients with carotid atherosclerotic plaques who underwent carotid vessel wall magnetic resonance imaging between 2002−2005 and 2012−2015 were retrospectively recruited.Plaque morphology[including mean wall area,wall thickness,and maximum normalized wall index(NWI)]and composition[including calcification,intraplaque hemorrhage,and lipid-rich necrotic core(LRNC)]in symptomatic carotid arteries were evaluated and compared between patients in these two time periods.RESULTS A total of 258 patients,including 129 patients in the 2002−2005 cohort and 129 patients in the 2012−2015 cohort,were recruited.Statin use(49.6%vs.32.6%,P=0.004)and hypertension(76.0%vs.62.8%,P=0.015)were significantly more common in the 2012-2015 cohort than in the 2002−2005 cohort.Patients in the 2012−2015 cohort also exhibited significantly low plaque burden parameters(all P<0.05),as well as a lower prevalence(68.2%vs.89.9%,P<0.001)and volume percentages of LRNC(11.2%±14.2%vs.25.7%±17.7%,P<0.001).These differences remained significant after adjustment for clinical factors.The differences in the volume percentages of LRNC also remained significant after an additional adjustment for maximum NWI(P<0.001).CONCLUSIONS Patients in the 2012−2015 cohort had a lower plaque burden and volume percentages of LRNC in symptomatic carotid arteries than those in the 2002−2005 cohort.These findings indicate that carotid plaques in the recent cohort had a lower severity and vulnerability.