Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Konyang University Hospital, Daejeon, Republic of Korea.
Cardiovasc Ther. 2020 Dec 30;2020:6617506. doi: 10.1155/2020/6617506. eCollection 2020.
High-risk carotid plaque remains an important risk factor for atherosclerotic cardiovascular disease (ASCVD). We sought to evaluate the characteristics of carotid plaque and to find out the predictors for high-risk carotid plaque in asymptomatic Koreans.
Subjects ( = 801) without a history of ASCVD from 12 university hospitals in Korea underwent carotid ultrasound. The images were standardized at core laboratory. Morphologic characteristics of plaque were analyzed with laboratory and clinical characteristics. High-risk carotid plaque features included the highest quartile of carotid plaque score (cPS), irregular plaque surface, and hypoechoic and ulcerated plaque.
The carotid plaque prevalence was 22.1% (177/801 persons, 293 plaques). The plaque was increased with age ( < 0.001) and conventional ASCVD risk estimator ( < 0.001) and the most frequently found in bulb ( = 190, 64.8%). The number of the highest quartile of cPS was 44/177 (24.9%). Irregular plaque was seen in 20.8% out of total plaque (61/293) and was more frequent in the high-risk 10-year ASCVD risk group than in the low-risk group (36.1% vs. 15.8%, = 0.023). Hypoechoic and ulcerated plaques were seen in 14.3% (42/293) and 2% (6/293), respectively. The independent predictors for high-risk plaque were age ( = 0.052, < 0.001), HbA1c ( = 0.182, = 0.004), male ( = 0.118, = 0.006), hypertension ( = 0.090, = 0.032), and multiple plaques (OR: 4.810 (two plaques) and 8.621 (three plaques), all < 0.001).
This study suggests that high-risk carotid plaque was seen in 12.4% (99/801). The high-risk plaque was associated with diabetes control status reflected by the HbA1c level as well as traditional risk factors in asymptomatic Korean population.
高危颈动脉斑块仍然是动脉粥样硬化性心血管疾病（ASCVD）的一个重要危险因素。我们旨在评估无症状韩国人群中颈动脉斑块的特征，并找出高危颈动脉斑块的预测因素。
来自韩国 12 所大学医院的 801 名无 ASCVD 病史的受试者接受颈动脉超声检查。图像在核心实验室进行标准化。利用实验室和临床特征分析斑块的形态学特征。高危颈动脉斑块的特征包括颈动脉斑块评分（cPS）最高四分位数、斑块表面不规则和低回声及溃疡斑块。
颈动脉斑块的患病率为 22.1%（177/801 人，293 个斑块）。斑块随年龄（<0.001）和传统 ASCVD 风险评估器（<0.001）的增加而增加，最常发生于颈动脉窦（=190，64.8%）。cPS 最高四分位数的数量为 44/177（24.9%）。293 个斑块中，20.8%（61 个）为不规则斑块，高危 10 年 ASCVD 风险组的发生率高于低危组（36.1%比 15.8%，=0.023）。低回声和溃疡斑块的发生率分别为 14.3%（42/293）和 2%（6/293）。高危斑块的独立预测因素为年龄（=0.052，<0.001）、糖化血红蛋白（HbA1c）（=0.182，=0.004）、男性（=0.118，=0.006）、高血压（=0.090，=0.032）和多发性斑块（OR：两个斑块时为 4.810，三个斑块时为 8.621，均<0.001）。
本研究表明，高危颈动脉斑块的发生率为 12.4%（99/801）。高危斑块与 HbA1c 水平反映的糖尿病控制状况以及无症状韩国人群中的传统危险因素有关。
