Abstract P242: Carotid Plaque Characterization, Stenosis, and Intima-media Thickness According to Age and Gender in a Large Registry Cohort

Abstract

Background: Carotid intima-media thickness (CIMT) is a well-established predictor of cardiovascular disease events. Not well described, however, is the prevalence of plaque and stenosis severity and how this varies according to extent of CIMT, age, and gender. Methods: We evaluated the extent of carotid plaque and stenosis severity according to CIMT, age and gender in a large CIMT screening registry. We studied 9347 women and 12676 men (n=22,023) who received carotid ultrasound scans. The presence and severity of both carotid plaque and stenosis was compared according to extent of CIMT ( > 1 mm vs. <1 mm), age, and gender using the Chi-square test of proportions. Results: Among those aged <45 to > 80 years the prevalence of CIMT > 1 mm ranged from 0.13 to 29.3% in women and 0.6 to 40.1% in men, stenosis >50% from 0.1% to 14.9% in women and 0.1% to 13.2% in men, and mixed/soft plaque from 7.1% to 66.5% in women and 9.2% to 65.8% in men (all p<0.001 across age). While 6.6% of women and 8.5% of men with CIMT <1mm had >30% stenosis, this increased to 48.6% and 46.0%, respectively, in those with CIMT > 1 mm. Even when CIMT levels were <1 mm, >30% of persons demonstrated mixed or soft plaque. Of those with CIMT > 1mm, more than 70% had such mixed or soft plaque (Figure) and over 40% demonstrated stenoses of 30% or greater. Conclusions: We describe in a large CIMT registry study a substantial age-related increase in both men and women of CIMT, plaque presence and severity, as well as stenosis. Even in those with normal CIMT, mixed or soft plaque potentially prone to rupture was common, demonstrating the value in assessing for plaque when doing carotid ultrasound.