Abstract: Objective To analyze the influencing factors of carotid plaque formation and stability in patients with ischemic cerebrovascular disease based on secondary prevention. Methods A questionnaire survey and carotid artery color ultrasound examination were conducted on patients diagnosed with ischemic cerebrovascular disease who were admitted to a hospital in Beijing from January 2019 to December 2022 and had been recorded in the hospital medical record management system. The descriptive analysis method was used to analyze the formation and stability of the carotid plaque in the patients, and univariate and multivariate analysis methods were used to analyze the factors influencing carotid plaque formation and stability. Results A total of 2 050 patients with ischemic cerebrovascular disease were divided into 359 patients with plaque formation and 1 691 patients without plaque formation. Among the 359 patients with plaque formation, the plaque stability test showed that 162 patients had stable plaques and 197 patients had unstable plaques. The results of multivariate logistic regression analysis showed that age≥80 years old （OR=4.495）, concomitant hypertension （OR=2.199）, concomitant hyperhomo‐cysteinemia （OR=3.235）, and intracranial and extracranial artery stenosis （OR=2.807） were risk factors for the formation of carotid plaques in patients with ischemic cerebrovascular disease; Following medical advice to use antiplatelet drugs （OR=0.276） and a reasonable diet （OR=0.358） were protective factors in reducing the formation of carotid plaques in ischemic cerebrovascular disease. Age≥80 years old （OR=2.804） and concomitant hyperhomo‐cysteinemia （OR=2.707） were risk factors for the stability of carotid plaques in patients with ischemic cerebrovascular disease; Following medical advice to use antiplatelet drugs （OR=0.366） was a protective factor for the stability of carotid plaques in ischemic cerebrovascular disease. Conclusion Based on the secondary prevention analysis, it is found that the elderly and intracranial and extracranial artery stenosis are the risk factors affecting the formation and stability of carotid plaque in patients with ischemic cerebrovascular disease, and following medical advice to use antiplatelet drugs is a protective factor.

Key words: Ischemic cerebrovascular disease, Carotid plaque formation, Plaque stability, Influencing factor, Secondary prevention