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Comparison of carotid atherosclerotic plaques between subjects in Northern and Southern China: a Chinese atherosclerosis risk evaluation study
  1. Dandan Yang1,
  2. Yang Ji2,
  3. Dan Wang2,
  4. Hiroko Watase3,
  5. Daniel S Hippe4,
  6. Xihai Zhao5,
  7. Chun Yuan4
  1. 1Center for Brain Disorders Research, Capital Medical University and Beijing Institute of Brain Disorders, Beijing, China
  2. 2Department of Radiology, Fourth Hospital of Harbin Medical University, Harbin, Heilongjiang, China
  3. 3Department of Surgery, University of Washington, Seattle, Washington, USA
  4. 4Department of Radiology, University of Washington, Seattle, Washington, USA
  5. 5Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Tsinghua University, Beijing, China
  1. Correspondence to Dr. Xihai Zhao; xihaizhao{at}


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 χ2 test.

Results Compared with subjects in southern China, those in northern China had significantly greater areas for lumen (57.7±14.9 mm2 vs 50.4±18.3 mm2, p=0.009), wall (38.4±13.1 mm2 vs 31.9±11.7 mm2, p<0.001) and total vessel (96.1±20.2 mm2 vs 82.4±22.7 mm2, p=0.001) and mean wall thickness (1.25±0.43 mm vs 1.13±0.40 mm, p=0.019). χ2 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.

Trial registration number NCT02017756

  • artery
  • atherosclerosis
  • MRI
  • plaque

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  • Contributors XZ and CY conceived the overall study and handled funding and supervision. XZ, YJ and DW acquired and interpreted the data. DY, YJ and XZ drafted the manuscript. DY, YJ, XZ, HW and DH performed the statistical analysis. CY provided technology support and made critical revision to the manuscript. All authors read and approved the content of this manuscript.

  • Funding This study was supported by grants from the National Natural Science Foundation of China (81771825), Beijing Municipal Science and Technology Commission (D171100003017003), and the Ministry of Science and Technology of the People’s Republic of China (2017YFC1307904).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study protocol was approved by the institutional review board, and written consent form was obtained from each subject.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

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