EXPLORING THE RELATIONSHIP BETWEEN CARDIOVASCULAR RISK FACTORS AND CAROTID PLAQUE COMPONENTS IN A MULTI-ETHNIC COHORT USING 3T MRI: THE HELIUS STUDY

Objective: Carotid atherosclerotic plaque components, such as calcifications, lipid cores, and intraplaque haemorrhage (IPH), are important determinants of cerebrovascular disease risk. However, their associations with cardiovascular risk factors in middle-aged populations remain unclear. This study evaluates these associations in a multi-ethnic, population-based cohort. Design and method: We analysed 3T MRI images of the carotid arteries from 356 participants of Dutch, South-Asian Surinamese, and Moroccan descent from the HELIUS study. Multivariable logistic mixed regression models were used to examine associations between cardiovascular risk factors and plaque components. Results: At baseline, the mean age of participants was 54.0 years [IQR 48.0–59.0], and 42.1% were women. Calcifications were positively associated with smoking (OR 4.06, 95% CI 1.24–13.3), diabetes mellitus (OR 6.0, 95% CI 1.44–24.97), hypertension (OR 4.02, 95% CI 1.59–10.12), and a history of cardiovascular disease (OR 4.66, 95% CI 1.02–21.28). Dyslipidaemia was negatively associated with calcifications (OR 0.17, 95% CI 0.06–0.52), but this was mainly driven by use of lipid-lowering therapy. Diabetes mellitus was also associated with lipid cores (OR 3.2, 95% CI 1.36–7.49), while no significant associations were observed for IPH. Conclusions: In this middle-aged, multi-ethnic population, cardiovascular risk factors showed distinct associations with specific plaque components. These findings underscore the importance of considering plaque characteristics as independent and non-interchangeable contributors to cerebrovascular disease risk.