Background Intraplaque hemorrhage (IPH) has been shown to be a predictor of symptomatic carotid artery disease, independent of degree of carotid stenosis. The association between modifiable cardiovascular risk factors, demographics and lab values has not been extensively studied.

Methods We reviewed our institutional series of patients who have undergone dedicated carotid plaque imaging over a 3-year period and report the association between various demographic and clinical variables and the presence of plaque hemorrhage. Patients with dedicated carotid plaque imaging were categorized into two groups: those with IPH and those without.

Results 643 total patients were reviewed. 114 patients (17.7%) had intraplaque hemorrhage on carotid plaque imaging sequences compared to 529 patients (82.3%) without. Patients with IPH had a mean age of 76.0 years compared to 60.1 years in those without IPH (P≤0.0001). 79% of patients with IPH were male, compared to 49.5% without IPH (P≤0.0001). 39.5% of patients with IPH had coronary artery disease compared to 23.1% of patients without IPH (P=0.0003). The IPH group also had higher proportions of patients with hypertension (77.2% vs. 60.7%, P=0.009), hyperlipidemia (89.5% vs. 62.4%, P≤0.0001), diabetes mellitus (89.5% vs. 62.4%, P=0.01) and a history of tobacco smoking (63.2% vs. 52.6%, P=0.003) as compared those without IPH.

Conclusions IPH is associated with well-known non-modifiable and modifiable cardiovascular risk factors. Patients with these risk factors are therefore more likely to have IPH within carotid plaques as compared to patients without these risk factors. These factors likely play a role in IPH pathophysiology. Consideration of such risk factors is important in considering patients to be at risk for ischemic stroke from carotid plaque.

Disclosures A. Larson: None. J. Benson: None. G. Lanzino: None. W. Brinjikji: None.