TY - JOUR
T1 - Prevalence, vascular distribution, and multiterritorial extent of subclinical atherosclerosis in a middle-aged cohort the PESA (Progression of Early Subclinical Atherosclerosis) study
AU - Fernández-Friera, Leticia
AU - Peñalvo, José L.
AU - Fernández-Ortiz, Antonio
AU - Ibañez, Borja
AU - López-Melgar, Beatriz
AU - Laclaustra, Martín
AU - Oliva, Belén
AU - Mocoroa, Agustín
AU - Mendiguren, José
AU - De Vega, Vicente Martínez
AU - García, Laura
AU - Molina, Jesús
AU - Sánchez-González, Javier
AU - Guzmán, Gabriela
AU - Alonso-Farto, Juan C.
AU - Guallar, Eliseo
AU - Civeira, Fernando
AU - Sillesen, Henrik
AU - Pocock, Stuart
AU - Ordovás, José M.
AU - Sanz, Ginés
AU - Jiménez-Borreguero, Luis Jesús
AU - Fuster, Valentín
N1 - Publisher Copyright:
© 2015 American Heart Association, Inc.
PY - 2015/6/16
Y1 - 2015/6/16
N2 - Background-Data are limited on the presence, distribution, and extent of subclinical atherosclerosis in middle-aged populations. Methods and Results-The PESA (Progression of Early Subclinical Atherosclerosis) study prospectively enrolled 4184 asymptomatic participants 40 to 54 years of age (mean age, 45.8 years; 63% male) to evaluate the systemic extent of atherosclerosis in the carotid, abdominal aortic, and iliofemoral territories by 2-/3-dimensional ultrasound and coronary artery calcification by computed tomography. The extent of subclinical atherosclerosis, defined as presence of plaque or coronary artery calcification ≥1, was classified as focal (1 site affected), intermediate (2-3 sites), or generalized (4-6 sites) after exploration of each vascular site (right/left carotids, aorta, right/left iliofemorals, and coronary arteries). Subclinical atherosclerosis was present in 63% of participants (71% of men, 48% of women). Intermediate and generalized atherosclerosis was identified in 41%. Plaques were most common in the iliofemorals (44%), followed by the carotids (31%) and aorta (25%), whereas coronary artery calcification was present in 18%. Among participants with low Framingham Heart Study (FHS) 10-year risk, subclinical disease was detected in 58%, with intermediate or generalized disease in 36%. When longer-term risk was assessed (30-year FHS), 83% of participants at high risk had atherosclerosis, with 66% classified as intermediate or generalized. Conclusions-Subclinical atherosclerosis was highly prevalent in this middle-aged cohort, with nearly half of the participants classified as having intermediate or generalized disease. Most participants at high FHS risk had subclinical disease; however, extensive atherosclerosis was also present in a substantial number of low-risk individuals, suggesting added value of imaging for diagnosis and prevention.
AB - Background-Data are limited on the presence, distribution, and extent of subclinical atherosclerosis in middle-aged populations. Methods and Results-The PESA (Progression of Early Subclinical Atherosclerosis) study prospectively enrolled 4184 asymptomatic participants 40 to 54 years of age (mean age, 45.8 years; 63% male) to evaluate the systemic extent of atherosclerosis in the carotid, abdominal aortic, and iliofemoral territories by 2-/3-dimensional ultrasound and coronary artery calcification by computed tomography. The extent of subclinical atherosclerosis, defined as presence of plaque or coronary artery calcification ≥1, was classified as focal (1 site affected), intermediate (2-3 sites), or generalized (4-6 sites) after exploration of each vascular site (right/left carotids, aorta, right/left iliofemorals, and coronary arteries). Subclinical atherosclerosis was present in 63% of participants (71% of men, 48% of women). Intermediate and generalized atherosclerosis was identified in 41%. Plaques were most common in the iliofemorals (44%), followed by the carotids (31%) and aorta (25%), whereas coronary artery calcification was present in 18%. Among participants with low Framingham Heart Study (FHS) 10-year risk, subclinical disease was detected in 58%, with intermediate or generalized disease in 36%. When longer-term risk was assessed (30-year FHS), 83% of participants at high risk had atherosclerosis, with 66% classified as intermediate or generalized. Conclusions-Subclinical atherosclerosis was highly prevalent in this middle-aged cohort, with nearly half of the participants classified as having intermediate or generalized disease. Most participants at high FHS risk had subclinical disease; however, extensive atherosclerosis was also present in a substantial number of low-risk individuals, suggesting added value of imaging for diagnosis and prevention.
KW - Atherosclerosis
KW - Epidemiology
KW - Multidetector computed tomography
KW - Population
KW - Risk assessment
KW - Ultrasonography
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U2 - 10.1161/CIRCULATIONAHA.114.014310
DO - 10.1161/CIRCULATIONAHA.114.014310
M3 - Article
C2 - 25882487
AN - SCOPUS:84935425898
SN - 0009-7322
VL - 131
SP - 2104
EP - 2113
JO - Circulation
JF - Circulation
IS - 24
ER -