Comparison of carotid atherosclerotic plaques between subjects in Northern and Southern China: a Chinese atherosclerosis risk evaluation study

Background and purpose To investigate differences in the characteristics of carotid atherosclerotic plaques of symptomatic subjects in northern and southern China using MRI.Methods Sixty-three subjects in northern China(mean age:59.1±8.6 years,45 men)and 56 subjects in southern China(mean age:60.4±8.6 years,38 men)were included.All subjects underwent carotid artery multicontrast vessel wall MRI.Plaque morphology,calcification,lipid-rich necrotic core,intraplaque haemorrhage,luminal surface disruption and high-risk plaque were measured and identified.All plaque characteristics were compared between subjects in northern and southern China using Mann-Whitney U test or χ^(2) test.results Compared with subjects in southern China,those in northern China had significantly greater areas for lumen(57.7±14.9 mm^(2) vs 50.4±18.3 mm^(2),p=0.009),wall(38.4±13.1 mm^(2) vs 31.9±11.7 mm^(2),p<0.001)and total vessel(96.1±20.2 mm^(2) vs 82.4±22.7 mm^(2),p=0.001)and mean wall thickness(1.25±0.43 mm vs 1.13±0.40 mm,p=0.019).χ^(2) analysis showed that subjects in northern China tended to have a higher prevalence of intraplaque haemorrhage(14.3%vs 5.4%,p=0.106)and high-risk plaque(20.6%vs 10.7%,p=0.140)than those in southern China,although these differences were not statistically significant(all p>0.05).Conclusion Subjects in northern China have significantly larger vessel size and may have a higher prevalence of vulnerable plaques than those in southern China.Our findings provide additional perspective to optimise the management of cerebrovascular disease in individuals in different regions in China.