Ancestral differences in atherosclerotic plaque composition

Abstract

Background: Cardiovascular disease is still the leading cause of death worldwide (World health statics, 2023), which causes an estimated 17.9 million deaths each year. Atherosclerosis is the underlying cause of coronary artery disease. Recent studies have shown that individuals from different ancestral groups exhibit significant differences in the prevalence and severity of atherosclerosis, however present data on population differences in plaque composition is scarce. In this study we will examine whether plaque composition differs between European and non-European patients who have undergone an endarterectomy procedure. Methods: This is a retrospective analysis of two datasets of a large non-academic teaching hospital and an academic hospital in the Netherlands. We will use data from the Athero-Express Biobank study and the Athero-Express Genomics Study. The primary histological phenotype will be Plaque Vulnerability Index. Ordinal logistic regression was used to assess the effect of ancestry on plaque composition while adjusting for confounding factors. The factors were included patient’s ancestry, age and gender. Results: The result of the ordinal logistic regression analysis indicates that patients with a non-European ethnicity have higher risk of being in higher Plaque Vulnerability Index scale, compared to patients with a non-European ethnicity. The analysis showed a statistically significant difference (odds ratio 2.48, 95% CI 1.37-4.49, p-value 0.003) after adjusting for gender, age, used chips and year of operation. Conclusion: Our analysis showed that Europeans had significantly lower risk for plaque instability. These changes in plaque composition include more fat, more intraplaque hemorrhage, more macrophages, and less smooth muscle cells.