Abstract Body: Background
Prior studies have demonstrated associations between eosinophil activation products and incident stroke. We sought to investigate associations between blood eosinophil count and imaging markers of atherosclerosis (carotid artery plaque [CAP] and coronary artery calcium [CAC]) in the Multi-Ethnic Study of Atherosclerosis (MESA).

Methods
The MESA enrolled adults aged 45-84 years, free of atherosclerotic cardiovascular disease (ASCVD) at baseline. ASCVD risk factors, blood eosinophils, CAP presence and score (0-12) and CAC presence and Agatston score were measured at exam 5. Logistic and linear regression models were employed to test the association of blood eosinophils, CAP and CAC presence and score (log[score+1]) adjusted for biologic confounders.

Results
The 2,166 participants were a mean (standard deviation [SD]) 69.6 (9.3) years old, 53% female, 29% Hispanic, 28% Black, 1% Chinese. The median (interquartile range) eosinophil count was 0.1 (0.1, 0.2)x10E3/uL, CAP score= 2 (0,4) and CAC score= 45 (0, 292) Agatston units. In risk-factor adjusted models (Table 1; model 5), increased blood eosinophil count (per 1 SD [0.15 x10E3/uL]) was associated with CAP (β = 0.05 [95% CI 0.02-0.08, p = 0.001) and CAC (β = 0.11, [95% CI: 0.01-0.21], p = 0.03) score. Similar associations were seen with eosinophils and CAP (Odds ratio [OR] = 1.12, [95% CI: 1.01-1.25], p = 0.03) and CAC (OR = 1.15, [95% CI: 1.02-1.30], p = 0.02) presence.

Conclusions
In a large, contemporary, multiethnic, U.S. cohort, blood eosinophils were strongly associated with imaging measures of atherosclerosis even after adjustment for ASCVD risk factors. These data suggest potential roles of T2/eosinophilic inflammation in atherosclerosis.