Histological Features of Symptomatic Carotid Plaques in Relation to Age and Smoking

Rates of incident and recurrent cardiovascular events rise steadily with age, due partly to more extensive atherosclerotic burden. However, in patients with similarly severe symptomatic carotid stenosis, increasing age is associated with a greater risk of ipsilateral ischemic stroke. This effect may be due to age-related differences in the pathology of symptomatic carotid plaques. However, previous studies of plaque pathology in relation to age have not accounted for potential confounders, particularly smoking, which is often less prevalent in the elderly population undergoing endarterectomy. Method-We related patient age (<55, 55 to 64, 65 to 74, 75+ years) and smoking habit (never, exsmoker, recent smoker, and current smoker; and number of cigarettes smoked per day) to detailed histological assessments of 526 carotid plaques from consecutive patients undergoing carotid endarterectomy for symptomatic carotid stenosis.