Carotid plaque characteristics and their association with cardiovascular risk factors and coronary atherosclerosis in a middle-aged population
Good, Elin ; Soto, Oscar ; Bilos, Linda LU ; Ahlström, Håkan ; Bianchessi, Tamara ; Engvall, Jan ; Gonçalves, Isabel LU
; Troung, My
; Hjelmgren, Ola
and Marlevi, David
, et al.
(2026)
In Journal of Cardiovascular Magnetic Resonance
28(1).
- Abstract
Background Carotid and coronary atherosclerosis are critical determinants of cardiovascular risk, yet their interrelationship in middle-aged populations is incompletely understood. This study assessed carotid plaque composition, risk-factor associations, coronary disease, and sex differences in a subclinical cohort. Methods Within the Swedish CArdioPulmonary bioImage Study, 533 asymptomatic individuals aged 50–64 years with carotid plaque ≥2.7 mm on ultrasound underwent 3T multi-contrast carotid cardiovascular magnetic resonance (CMR) and coronary computed tomography angiography. Carotid plaque characteristics were determined manually using established criteria on multi-contrast weighted carotid CMR. Bayesian regression models evaluated... (More)
Background Carotid and coronary atherosclerosis are critical determinants of cardiovascular risk, yet their interrelationship in middle-aged populations is incompletely understood. This study assessed carotid plaque composition, risk-factor associations, coronary disease, and sex differences in a subclinical cohort. Methods Within the Swedish CArdioPulmonary bioImage Study, 533 asymptomatic individuals aged 50–64 years with carotid plaque ≥2.7 mm on ultrasound underwent 3T multi-contrast carotid cardiovascular magnetic resonance (CMR) and coronary computed tomography angiography. Carotid plaque characteristics were determined manually using established criteria on multi-contrast weighted carotid CMR. Bayesian regression models evaluated associations between cardiovascular risk factors and coronary atherosclerosis. Results Lipid-rich necrotic core (LRNC) was present in 60% (320/533) and intraplaque hemorrhage (IPH) in 5.4% (29/533); calcification occurred in 48.6% (259/533). Maximum carotid wall thickness was 1.8 (1.6-2.0) mm, and mean lumen area 31.3 (26.7-36.1) mm². Coronary atherosclerosis was present in 63.6% (339/533) of participants, with ≥50% stenosis in 12.9% (69/533), and coronary artery calcium score >400 in 12.8% (68/533). Men (N = 367) had larger carotid lumen area, mean wall area, and maximum wall thickness (all p < 0.001) than women (N = 166), differences that persisted after body-surface-area adjustment (all p < 0.01). LRNC was present in 66% (242/367) of men compared to 47% (78/166) of women (p < 0.001). LRNC presence was not associated with coronary atherosclerosis, whereas IPH was associated with coronary involvement. Conclusion In middle-aged individuals, distinct cardiovascular risk factors were positively linked to the presence and volume of LRNC and calcified plaques. The substantial prevalence of high-risk plaque features, particularly LRNC and especially in men, highlights a significant subclinical carotid disease burden.
(Less)
- author
- Good, Elin
; Soto, Oscar
; Bilos, Linda
LU
; Ahlström, Håkan
; Bianchessi, Tamara
; Engvall, Jan
; Gonçalves, Isabel
LU
; Troung, My
; Hjelmgren, Ola
and Marlevi, David
, et al. (More)
- Good, Elin
; Soto, Oscar
; Bilos, Linda
LU
; Ahlström, Håkan
; Bianchessi, Tamara
; Engvall, Jan
; Gonçalves, Isabel
LU
; Troung, My
; Hjelmgren, Ola
; Marlevi, David
; Wegmann, Bertil
and Dyverfeldt, Petter
(Less)
- organization
- publishing date
- 2026-06
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cardiovascular risk factors, Carotid atherosclerosis, Coronary artery disease, Lipid-rich necrotic core, Magnetic resonance angiography
- in
- Journal of Cardiovascular Magnetic Resonance
- volume
- 28
- issue
- 1
- article number
- 102686
- publisher
- Elsevier
- external identifiers
-
- pmid:41519270
- scopus:105036436585
- ISSN
- 1097-6647
- DOI
- 10.1016/j.jocmr.2026.102686
- language
- English
- LU publication?
- yes
- id
- 3ad901ef-0ffc-4ff3-91fc-d48f712d5947
- date added to LUP
- 2026-05-25 10:48:58
- date last changed
- 2026-09-02 00:53:15
@article{3ad901ef-0ffc-4ff3-91fc-d48f712d5947,
abstract = {{<p>Background Carotid and coronary atherosclerosis are critical determinants of cardiovascular risk, yet their interrelationship in middle-aged populations is incompletely understood. This study assessed carotid plaque composition, risk-factor associations, coronary disease, and sex differences in a subclinical cohort. Methods Within the Swedish CArdioPulmonary bioImage Study, 533 asymptomatic individuals aged 50–64 years with carotid plaque ≥2.7 mm on ultrasound underwent 3T multi-contrast carotid cardiovascular magnetic resonance (CMR) and coronary computed tomography angiography. Carotid plaque characteristics were determined manually using established criteria on multi-contrast weighted carotid CMR. Bayesian regression models evaluated associations between cardiovascular risk factors and coronary atherosclerosis. Results Lipid-rich necrotic core (LRNC) was present in 60% (320/533) and intraplaque hemorrhage (IPH) in 5.4% (29/533); calcification occurred in 48.6% (259/533). Maximum carotid wall thickness was 1.8 (1.6-2.0) mm, and mean lumen area 31.3 (26.7-36.1) mm². Coronary atherosclerosis was present in 63.6% (339/533) of participants, with ≥50% stenosis in 12.9% (69/533), and coronary artery calcium score >400 in 12.8% (68/533). Men (N = 367) had larger carotid lumen area, mean wall area, and maximum wall thickness (all p < 0.001) than women (N = 166), differences that persisted after body-surface-area adjustment (all p < 0.01). LRNC was present in 66% (242/367) of men compared to 47% (78/166) of women (p < 0.001). LRNC presence was not associated with coronary atherosclerosis, whereas IPH was associated with coronary involvement. Conclusion In middle-aged individuals, distinct cardiovascular risk factors were positively linked to the presence and volume of LRNC and calcified plaques. The substantial prevalence of high-risk plaque features, particularly LRNC and especially in men, highlights a significant subclinical carotid disease burden.</p>}},
author = {{Good, Elin and Soto, Oscar and Bilos, Linda and Ahlström, Håkan and Bianchessi, Tamara and Engvall, Jan and Gonçalves, Isabel and Troung, My and Hjelmgren, Ola and Marlevi, David and Wegmann, Bertil and Dyverfeldt, Petter}},
issn = {{1097-6647}},
keywords = {{Cardiovascular risk factors; Carotid atherosclerosis; Coronary artery disease; Lipid-rich necrotic core; Magnetic resonance angiography}},
language = {{eng}},
number = {{1}},
publisher = {{Elsevier}},
series = {{Journal of Cardiovascular Magnetic Resonance}},
title = {{Carotid plaque characteristics and their association with cardiovascular risk factors and coronary atherosclerosis in a middle-aged population}},
url = {{http://dx.doi.org/10.1016/j.jocmr.2026.102686}},
doi = {{10.1016/j.jocmr.2026.102686}},
volume = {{28}},
year = {{2026}},
}