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 - Fernandez-Friera, Leticia
AU - Penalvo, Jose L.
AU - Fernandez-Ortiz, Antonio
AU - Ibanez, Borja
AU - Lopez-Melgar, Beatriz
AU - Laclaustra, Martin
AU - Oliva, Belen
AU - Mocoroa, Agustin
AU - Mendiguren, Jose
AU - Martinez de Vega, Vicente
AU - Garcia, Laura
AU - Molina, Jesus
AU - Sanchez-Gonzalez, Javier
AU - Guzman, Gabriela
AU - Alonso-Farto, Juan C.
AU - Guallar, Eliseo
AU - Civeira, Fernando
AU - Sillesen, Henrik
AU - Pocock, Stuart
AU - Ordovas, Jose M.
AU - Sanz, Gines
AU - Jesus Jimenez-Borreguero, Luis
AU - Fuster, Valentin
N1 - FTX
PY - 2015
Y1 - 2015
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
KW - CORONARY-HEART-DISEASE
KW - CARDIOVASCULAR-DISEASE
KW - ARTERY CALCIUM
KW - YOUNG-ADULTS
KW - RISK
KW - EVENTS
KW - ASSOCIATION
KW - DESIGN
KW - HEALTH
KW - PLAQUE
U2 - 10.1161/CIRCULATIONAHA.114.014310
DO - 10.1161/CIRCULATIONAHA.114.014310
M3 - A1: Web of Science-article
SN - 0009-7322
VL - 131
SP - 2104
EP - 2113
JO - Circulation
JF - Circulation
IS - 24
ER -