Prevalence, Vascular Distribution, and Multiterritorial Extent of Subclinical Atherosclerosis in a Middle-Aged Cohort

• DOI: 10.1161/circulationaha.114.014310
• Publication Date: 2015-04-17T03:02:24Z
• Authors: Leticia Fernández...; José L. Peñalvo; Antonio Fernández...; Borja Ibañez; Beatriz López-Melgar; Martín Laclaustra; Belén Oliva; Agustín Mocoroa; José Mendiguren; Vicente Martínez ...; Laura García; Jesús Molina; Javier Sánchez-Go...; Gabriela Guzmán; Juan C. Alonso-Farto; Eliseo Guallar; Fernando Civeira; Henrik Sillesen; Stuart Pocock; José M. Ordovás; Ginés Sanz; Luis Jesús Jiméne...; Valentín Fuster
• Keywords: Subclinical infection; Coronary atherosclerosis; Framingham Heart Study

Background— Data are limited on the presence, distribution, and extent of subclinical atherosclerosis in middle-aged populations. Methods Results— The PESA (Progression Early Subclinical Atherosclerosis) study prospectively enrolled 4184 asymptomatic participants 40 to 54 years age (mean age, 45.8 years; 63% male) evaluate systemic carotid, abdominal aortic, iliofemoral territories by 2-/3-dimensional ultrasound coronary artery calcification computed tomography. atherosclerosis, defined as presence plaque or ≥1, was classified focal (1 site affected), intermediate (2–3 sites), generalized (4–6 sites) after exploration each vascular (right/left carotids, aorta, right/left iliofemorals, arteries). present (71% men, 48% women). Intermediate identified 41%. Plaques were most common iliofemorals (44%), followed carotids (31%) aorta (25%), whereas 18%. Among with low Framingham Heart Study (FHS) 10-year risk, disease detected 58%, 36%. When longer-term risk assessed (30-year FHS), 83% at high had 66% generalized. Conclusions— highly prevalent this cohort, nearly half having disease. Most FHS disease; however, extensive also a substantial number low-risk individuals, suggesting added value imaging for diagnosis prevention. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT01410318.