ABSTRACT NUMBER: ESOC2026A1232 CAROTID ATHEROSCLEROTIC PLAQUE WIDTH AND PLAQUE PROGRESSION AS MARKERS FOR RISK OF DEATH

Abstract Background and aims Severity of carotid stenosis and RADS classification of atherosclerotic plaque are markers for stroke and cardiac death. ANTIQUE study (ClinicalTrials ID:NCT02360137) aimed to analyze more plaque characteristics. The aim of our analysis was to evaluate the relationship between both carotid atherosclerotic plaque width and plaque progression and the risk of death during 10-year follow-up in patients from ANTIQUE study. Methods We analyzed 10-year follow-up data from patients enrolled in the ANTIQUE study. All participants underwent annual B-mode ultrasound with measurement of maximal carotid plaque width in transverse view. Plaques were categorized by maximal width (A: ≤0.25; B: 0.26-0.35; C: 0.36-0.45; D: 0.46-0.55; E: >0.55 mm). Plaque progression was defined as difference between first and last measurements and classified as stable plaques (1: ≤0.2 mm), minor (2: 0.21–1.0 mm), or major (3: >1.0 mm) plaque progressions. Dates and causes of death were obtained from the national patient registry. Survival was assessed using Kaplan–Meier analysis and compared with log-rank test. Results Total of 1,652 patients (749 men; mean age 68.7±9.4 years) were included to the analysis. Within 10 years, 537 (32.5%) patients died (294 males; mean age 74.4+/-6.9 years). Increasing plaque width and greater plaque progression were both significantly associated with higher mortality risk (both p<0.01; Figure 1). These associations were consistent across plaque size and progression categories. Conclusions Carotid plaque width and plaque progression are strong predictors of long-term mortality. Routine longitudinal plaque measurement may improve risk stratification and support personalized preventive strategies in patients with carotid atherosclerosis. Conflict of interest David Skoloudik: nothing to disclose. David Pakizer: nothing to disclose. Istvan Szegedi: nothing to disclose. David Netuka: nothing to disclose. Figure 1 - belongs to Results