Research Article Predictors for High-Risk Carotid Plaque in Asymptomatic Korean Population Chae Won Jang , Yong Kyun Kim , Ki-Hong Kim , Achangwa Chiara , Moo-Sik Lee , and Jang-Ho Bae Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Konyang University Hospital, Daejeon, Republic of Korea Correspondence should be addressed to Jang-Ho Bae; janghobae@yahoo.co.kr Received 24 November 2020; Revised 15 December 2020; Accepted 16 December 2020; Published 30 December 2020 Academic Editor: John D. Imig Copyright © 2020 Chae Won Jang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Aims. High-risk carotid plaque remains an important risk factor for atherosclerotic cardiovascular disease (ASCVD). We sought to evaluate the characteristics of carotid plaque and to find out the predictors for high-risk carotid plaque in asymptomatic Koreans. Methods. Subjects (n = 801) without a history of ASCVD from 12 university hospitals in Korea underwent carotid ultrasound. The images were standardized at core laboratory. Morphologic characteristics of plaque were analyzed with laboratory and clinical characteristics. High-risk carotid plaque features included the highest quartile of carotid plaque score (cPS), irregular plaque surface, and hypoechoic and ulcerated plaque. Results. The carotid plaque prevalence was 22.1% (177/801 persons, 293 plaques). The plaque was increased with age (p <0:001) and conventional ASCVD risk estimator (p <0:001) and the most frequently found in bulb (n = 190, 64.8%). The number of the highest quartile of cPS was 44/177 (24.9%). Irregular plaque was seen in 20.8% out of total plaque (61/293) and was more frequent in the high-risk 10-year ASCVD risk group than in the low-risk group (36.1% vs. 15.8%, p =0:023). Hypoechoic and ulcerated plaques were seen in 14.3% (42/293) and 2% (6/293), respectively. The independent predictors for high-risk plaque were age (β =0:052, p <0:001), HbA1c (β =0:182, p =0:004), male (β =0:118, p =0:006), hypertension (β =0:090, p =0:032), and multiple plaques (OR: 4.810 (two plaques) and 8.621 (three plaques), all p < 0:001). Conclusions. This study suggests that high-risk carotid plaque was seen in 12.4% (99/801). The high-risk plaque was associated with diabetes control status reflected by the HbA1c level as well as traditional risk factors in asymptomatic Korean population. 1. Introduction Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of morbidity and mortality in the world. According to the national statistics of Korea in 2018 [1], heart disease was the second cause of death (62.4 persons/100,000) increasing from third cause (43.4 persons/100,000) in 2008. Cerebrovas- cular disease is the fourth cause of death (44.7 per- sons/100,000) in 2018. Routine measurement of carotid intima-media thickness (CIMT) is no longer recommended to assess atherosclerosis. However, carotid plaque burden and thickness are reported as a surrogate of atherosclerosis and can predict future ASCVD [2, 3]. Epidemiologic and clinical importance of plaque was investigated in many studies [4, 5]. The Atherosclerosis Risk in Communities (ARIC) study [5] showed that 33.6% of carotid plaque prevalence and whites (34.4%) had higher prevalence than blacks (31.4%). Caucasians had more plaque formation and higher plaque score than African-American, Hispanic, and Chinese over a decade in the Multi-Ethnic Study of Atherosclerosis (MESA) study [4]. Free-living Koreans in their 35 to 64 years had carotid plaque (17%) [6]. Carotid plaque was associated with cardiovascular events in both healthy population and patients with coronary artery disease [7–10]. Specific morphological features of carotid plaque such as echogenicity, ulcerated, or irregular surface are an important Hindawi Cardiovascular erapeutics Volume 2020, Article ID 6617506, 8 pages https://doi.org/10.1155/2020/6617506