Background The clinical manifestations of cerebrovascular disease are known to differ between the Chinese and United States(US)populations as do the plaque features on imaging.Objectives The aim of this study was to i...Background The clinical manifestations of cerebrovascular disease are known to differ between the Chinese and United States(US)populations as do the plaque features on imaging.Objectives The aim of this study was to investigate and compare the histological features of excised carotid plaques from Chinese and US patients.Methods Carotid endarterectomy specimens collected from two prospective studies were included.The entire plaque was serially sectioned(10-µm thickness)at 0.5-1 mm intervals.Hematoxylin and eosin staining and Mallory’s trichrome staining were performed.The morphology and components of the plaques were measured and compared between the two groups.Results A total of 1152 histological sections from 75 Chinese patients and 1843 sections from 111 US patients were analyzed.The Chinese group had significantly smaller minimum lumen diameters(median:1.1 vs.1.3 mm,p=0.046)and a larger percent wall volume(median:74%vs.70%,p=0.018)than the US group.After adjusting for confounding factors,carotid plaques in the Chinese population had larger lipid pools(β=10.0%,95%CI:4.9 to 15.9%),more recent intraplaque hemorrhage(IPH;β=8.4%,95%CI:4.5 to 12.7%),less late IPH(β=-8.2%,95%CI:-11.3 to-5.4),and fewer fibrous cap disruptions(45%vs.67%,p=0.061).Chinese plaques were more homogeneous and had a higher percentage of plaques with features of xanthomas than did US plaques(20%vs 2.7%,p<0.001).Conclusions The histology of Chinese plaques differs significantly from that of U.S.plaques,suggesting substantial differences in the pathophysiology of atherosclerotic cerebrovascular disease between Chinese and North American populations,which indicates a need for a different management approach.展开更多
基金funded by the National Institutes of Health(R01 NS083503)the National Natural Science Foundation of China(81361120402 and 62271061)the Beijing Natural Science Foundation(L232130).
文摘Background The clinical manifestations of cerebrovascular disease are known to differ between the Chinese and United States(US)populations as do the plaque features on imaging.Objectives The aim of this study was to investigate and compare the histological features of excised carotid plaques from Chinese and US patients.Methods Carotid endarterectomy specimens collected from two prospective studies were included.The entire plaque was serially sectioned(10-µm thickness)at 0.5-1 mm intervals.Hematoxylin and eosin staining and Mallory’s trichrome staining were performed.The morphology and components of the plaques were measured and compared between the two groups.Results A total of 1152 histological sections from 75 Chinese patients and 1843 sections from 111 US patients were analyzed.The Chinese group had significantly smaller minimum lumen diameters(median:1.1 vs.1.3 mm,p=0.046)and a larger percent wall volume(median:74%vs.70%,p=0.018)than the US group.After adjusting for confounding factors,carotid plaques in the Chinese population had larger lipid pools(β=10.0%,95%CI:4.9 to 15.9%),more recent intraplaque hemorrhage(IPH;β=8.4%,95%CI:4.5 to 12.7%),less late IPH(β=-8.2%,95%CI:-11.3 to-5.4),and fewer fibrous cap disruptions(45%vs.67%,p=0.061).Chinese plaques were more homogeneous and had a higher percentage of plaques with features of xanthomas than did US plaques(20%vs 2.7%,p<0.001).Conclusions The histology of Chinese plaques differs significantly from that of U.S.plaques,suggesting substantial differences in the pathophysiology of atherosclerotic cerebrovascular disease between Chinese and North American populations,which indicates a need for a different management approach.
