Sex-Specific Associations of Carotid Plaque Calcification Subtypes with Stroke, TIA, and Retinal Ischemia

The study examined the relationship between calcification in carotid plaques and cerebrovascular events in 483 patients (328 men) undergoing carotid endarterectomy. Women had more plaque calcification than men (median 15.8% versus 10.8%). Symptomatic plaques showed lower calcification than asymptomatic plaques, primarily in men. In men, plaques associated with stroke were characterized by lower calcification than asymptomatic plaques. In women, plaques associated with TIA showed higher calcification than stroke-associated plaques. Retinal infarction was associated with higher nodular calcification than stroke. The results suggest that although calcification stabilizes plaque, its clinical implications depend on its morphological subtype and vary according to sex and type of neurological event.