Factors associated with the presence of prognostically unfavorable carotid atherosclerosis in men and women over age 40

Abstract

Objective: to investigate the frequency of carotid atherosclerotic plaques (CP) with a maximum height ≥ 2.5 mm and to establish clinical and laboratory predictors of this type of carotid atherosclerosis.
Materials and Methods. The study included 435 patients aged 40-75 years of different cardiovascular risk (CVR) referred by the attending physician for duplex scanning (DS) of carotid arteries to clarify CVR and/or to screen hemodynamically significant carotid artery disease. When an  CP was detected, its thickness (height) was determined at the site of the most protruding plaque area, fixing the maximum value of all maximum heights available in the CP patient.
Results. According to the baseline CVR assessment of patients at study inclusion, 74 (17.0%) were classified as low CVR, 120 (27.6%) as moderate CVR, 84 (19.3%) as high CVR, and 157 (36.1%) as very high CVR. CP detected in 73.6% of cases, and CP with a maximum height of ≥ 2.5 mm detected in 19.8%. On multivariate analysis, age (OR 1.261; 95% CI 1.050–1.515; p = 0.013) and type 2 DM (OR 16.03; 95% CI 1.096–234.5; p = 0.043) demonstrated independent predictive value for the presence of CP ≥ 2.5 mm. CP ≥ 2.5 mm were detected in 56 (24.0%) men and 30 (14.8%) women (p = 0.009). Significant differences founded between men and women in factors associated with the presence of CP with a maximum height of ≥2.5 mm. Thus, in men, in contrast to women, smoking and fibrinogen levels were statistically significant predictors of CP ≥ 2.5 mm. On the other hand, abdominal obesity, hypertriglyceridemia, hyperuricemia and decreased eGFR were predictive values in women in contrast to men.
Conclusion. In patients aged 40-75 years with various CVD, CP with a maximum height ≥2.5 mm detected in 19.8% of cases. According to multivariate analysis, age and type 2 diabetes mellitus were independent predictors of carotid CP with a maximum height ≥ 2.5 mm. The profile of factors associated with the presence of these CP differed significantly in men and women.