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

Ming-Ming LU; Peng PENG; Thomas S.Hatsukami; Fei YUAN; Yuan-Yuan CUI; Li-Chen ZHANG; Hui-Yu QIAO; Chun YUAN; Jian-Ming CAI; Xi-Hai ZHAO

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.