Association between age and progression of carotid artery atherosclerosis: a serial high resolution magnetic resonance imaging study
This study aimed to investigate the association between age and progression of carotid atherosclerotic plaques using serial high resolution magnetic resonance imaging (MRI). Symptomatic patients who had carotid atherosclerosis with 30–70% stenosis were enrolled in this study. Carotid MRI was performed at baseline and follow-up time point (≥ 6 months after baseline), respectively. The characteristics of carotid plaque progression among different age groups (> 75 years old, 60–75 years old and < 60 years old) were compared. Logistic regression was performed to relate age with carotid plaque progression. Of recruited 84 patients, 73 (mean age, 66.5 ± 11.4 years old; males, 82.2%) with 96 plaques were included in the final analysis. Compared with younger patients, older ones had significantly higher incidence of calcification in carotid plaques (> 75 years old: 91.3%, 60–75 years old: 65.7% and < 60 years old: 55.3%, p = 0.013), greater annual change of carotid wall volume (> 75 years old: 39.0 (4.3–104.6) mm3, 60–75 years old: 28.7 (− 28.0 to 73.7) mm3 and < 60 years old: 4.8 (− 27.1–31.9) mm3, p = 0.032) and maximum carotid wall area (> 75 years old: 6.1 (− 3.5 to 17.2) mm2, 60–75 years old: 2.4 (− 4.7 to 15.1) mm2 and < 60 years old: 1.4 (− 5.8 to 6.9) mm2, p = 0.046). Age (OR 1.44; 95% CI 1.10–1.89; p = 0.009) and hypertension (OR 4.61; 95% CI 1.41–15. 02; p = 0.011) were independent predictors in discriminating upper quartile of annual change of carotid wall volume after adjusting for all clinical factors. Older patients have faster progression rate in carotid plaques than younger ones and age is independently associated with carotid plaque progression. Our findings suggest that the carotid plaques of older patients need to be monitored more frequently.
KeywordsCarotid atherosclerosis Disease progression Risk factors Magnetic resonance imaging
This study was supported by the Grants of National Natural Science Foundation of China (81771825), Beijing Science and Technology Project (D171100003017003), and Ministry of Science and Technology of China (2017YFC1307904).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
The study protocol conforms to the ethical guidelines of the 1975 Declaration of Helsinki and was approved by Institution’s ethics committee on research on humans.
Informed consent was obtained from all individual participants included in the study.
- 1.Spence JD, Eliasziw M, DiCicco M, Hackam DG, Galil R, Lohmann T (2002) Carotid plaque area: a tool for targeting and evaluating vascular preventive therapy. Stroke 33:2916–2922. https://doi.org/10.1161/01.STR.0000042207.16156.B9 CrossRefGoogle Scholar
- 5.Amer MS, Khater MS, Omar OH, Mabrouk RA, Mostafa SA (2014) Association between framingham risk score and subclinical atherosclerosis among elderly with both Type 2 diabetes mellitus and healthy subjects. Am J Cardiovasc Dis 4:14–19Google Scholar
- 9.Saam T, Yuan C, Chu B, Takaya N, Underhill H, Cai J et al (2007) Predictors of carotid atherosclerotic plaque progression as measured by noninvasive magnetic resonance imaging. Atherosclerosis 194:e34–e42. https://doi.org/10.1016/j.atherosclerosis.2006.08.016 CrossRefGoogle Scholar
- 15.Li D, Zhao H, Chen X, Chen S, Qiao H, He L et al (2018) Identification of intraplaque haemorrhage in carotid artery by simultaneous non-contrast angiography and intraplaque haemorrhage (SNAP) imaging: a magnetic resonance vessel wall imaging study. Eur Radiol 28:1681–1686. https://doi.org/10.1007/s00330-017-5096-1 CrossRefGoogle Scholar
- 16.Saam T, Ferguson MS, Yarnykh VL, Takaya N, Xu D, Polissar NL et al (2005) Quantitative evaluation of carotid plaque composition by in vivo MRI. Arterioscler Thromb Vasc Biol 25:234–239. https://doi.org/10.1161/01.ATV.0000149867.61851.31 CrossRefGoogle Scholar
- 20.van Lammeren GW, Reichmann BL, Moll FL, Bots ML, de Kleijn DP, de Vries JP et al (2011) Atherosclerotic plaque vulnerability as an explanation for the increased risk of stroke in elderly undergoing carotid artery stenting. Stroke 42:2550–2555. https://doi.org/10.1161/STROKEAHA.110.607382 CrossRefGoogle Scholar
- 21.van Gils MJ, Bodde MC, Cremers LG, Dippel DW, van der Lugt A (2013) Determinants of calcification growth in atherosclerotic carotid arteries; a serial multi-detector CT angiography study. Atherosclerosis 227:95–99. https://doi.org/10.1016/j.atherosclerosis.2012.12.017 CrossRefGoogle Scholar
- 23.Banach M, Serban C, Sahebkar A, Mikhailidis DP, Ursoniu S, Ray KK,et al (2015) Impact of statin therapy on coronary plaque composition: a systematic review and meta-analysis of virtual histology intravascular ultrasound studies. BMC Med 13: 229. https://doi.org/10.1186/s12916-015-0459-4 CrossRefGoogle Scholar
- 26.Cai J, Hatsukami TS, Ferguson MS, Kerwin WS, Saam T, Chu B et al (2005) In vivo quantitative measurement of intact fibrous cap and lipid-rich necrotic core size in atherosclerotic carotid plaque: comparison of high-resolution, contrast-enhanced magnetic resonance imaging and histology. Circulation 112:3437–3444. https://doi.org/10.1161/CIRCULATIONAHA.104.528174 CrossRefGoogle Scholar
- 27.Takaya N, Yuan C, Chu B, Saam T, Underhill H, Cai J et al (2006) Association between carotid plaque characteristics and subsequent ischemic cerebrovascular events: a prospective assessment with MRI-initial results. Stroke 37:818–823. https://doi.org/10.1161/01.STR.0000204638.91099.91 CrossRefGoogle Scholar