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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2005;25:611.)
© 2005 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Carotid Plaque Composition Differs Between Ethno-Racial Groups

An MRI Pilot Study Comparing Mainland Chinese and American Caucasian Patients

T. Saam; J.M. Cai; Y.Q. Cai; N.Y. An; A. Kampschulte; D. Xu; W.S. Kerwin; N. Takaya; N.L. Polissar; T.S. Hatsukami; C. Yuan

From the Department of Radiology (T.S., A.K., D.X., W.S.K., N.T., C.Y.), University of Washington, Seattle; the Department of Radiology (J.M.C., Y.Q.C., N.Y.A.), PLA General Hospital, Beijing, China; The Mountain-Whisper-Light Statistical Consulting (N.L.P.), Seattle, Wash; and the Department of Surgery (T.S.H.), University of Washington and VA Puget Sound Health Care System, Seattle.

Correspondence to Chun Yuan, Professor, Department of Radiology, 1959 NE Pacific St, Box 357115 Seattle, WA 98195. E-mail cyuan{at}u.washington.edu

Objective— Ethnicity-based research may identify new clues to the pathogenesis of atherosclerotic disease. Therefore, we sought to determine whether carotid lesions differ between 20 Chinese and 20 Caucasian Americans by MRI.

Methods and Results— Inclusion criteria were >50% stenosis as measured by duplex ultrasound and recent symptoms attributed to carotid artery disease. The patients were imaged in 2 centers (Beijing, China and Seattle, Wash) using a standardized protocol. Both carotid arteries were reviewed quantitatively (lumen, wall, outer wall, tissue components) and morphologically (lesion types, fibrous cap status). Significant differences between the Chinese and Americans were found for the mean size of the lipid/necrotic core (13.6 versus 7.8 mm²; P=0.002), percentage of slices with calcified type VII lesions (1.6 versus 12.4%; P=0.03), and percentage of slices with early type III lesions (19.3 versus 9.3%; P=0.02). Furthermore, the mean outer wall area in the common carotid artery was larger in the Chinese population (P=0.007).

Conclusions— This pilot study suggests that composition and morphology of atherosclerotic lesions in symptomatic carotid disease differ between ethno-racial groups. Quantitative MRI-based review of carotid atherosclerosis comparing plaque morphology and composition between ethno-racial groups is feasible, and future MRI studies may improve our understanding of the pathophysiology of this disease.

Twenty Chinese patients and 20 American Caucasian patients, all recently symptomatic, were imaged by MRI. Carotid lesions were bilaterally evaluated for plaque composition and plaque morphology. Plaque composition and morphology differed significantly between the ethno-racial groups. MRI is a promising tool to noninvasively study differences in atherosclerotic lesions across distinctive populations.

Key Words: atherosclerosis • carotid arteries • epidemiology • MRI

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