WSC 2026 | Carotid artery characteristics and plaque features across ethnic groups: a MESA analysis

There’s been a long-standing understanding that stroke risks vary by ethnicity and stroke outcomes vary by ethnicity. But there’s been limited exploration of how these outcomes might, outcome differences might relate to differences in the actual atherosclerotic markers in different ethnic groups. And the MESA study, a multi-ethnic stroke study, offered us this opportunity to explore this question. The most notable finding was that African-American participants in the study had greater measures of arterial stiffness. However, when we looked at how individual markers of risk were associated with different outcomes, that association itself didn’t vary much by ethnicity. So what that means is that different markers, imaging markers of atherosclerotic risk probably carry the same implications in a given patient regardless of ethnicity. What seems to differ is the prevalence of some of these markers, such as the arterial stiffness being more common among African-American participants. Now, how does this translate at a population level into our ability to explain some of the ethnic differences that we see in stroke outcomes, that remains to be seen and validated in other studies.

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