Association between age and progression of carotid artery atherosclerosis: a serial high resolution magnetic resonance imaging study

This study aimed to investigate the association between age and progression of carotid atherosclerotic plaques using serial high resolution magnetic resonance imaging (MRI). Symptomatic patients who had carotid atherosclerosis with 30–70% stenosis were enrolled in this study. Carotid MRI was performed at baseline and follow-up time point (≥ 6 months after baseline), respectively. The characteristics of carotid plaque progression among different age groups (> 75 years old, 60–75 years old and < 60 years old) were compared. Logistic regression was performed to relate age with carotid plaque progression. Of recruited 84 patients, 73 (mean age, 66.5 ± 11.4 years old; males, 82.2%) with 96 plaques were included in the final analysis. Compared with younger patients, older ones had significantly higher incidence of calcification in carotid plaques (> 75 years old: 91.3%, 60–75 years old: 65.7% and < 60 years old: 55.3%, p = 0.013), greater annual change of carotid wall volume (> 75 years old: 39.0 (4.3–104.6) mm 3 , 60–75 years old: 28.7 (− 28.0 to 73.7) mm 3 and < 60 years old: 4.8 (− 27.1–31.9) mm 3 , p = 0.032) and maximum carotid wall area (> 75 years old: 6.1 (− 3.5 to 17.2) mm 2 , 60–75 years old: 2.4 (− 4.7 to 15.1) mm 2 and < 60 years old: 1.4 (− 5.8 to 6.9) mm 2 , p = 0.046). Age (OR 1.44; 95% CI 1.10–1.89; p = 0.009) and hypertension (OR 4.61; 95% CI 1.41–15. 02; p = 0.011) were independent predictors in discriminating upper quartile of annual change of carotid wall volume after adjusting for all clinical factors. Older patients have faster progression rate in carotid plaques than younger ones and age is independently associated with carotid plaque progression. Our findings suggest that the carotid plaques of older patients need to be monitored more frequently.