Prevalence, Vascular Distribution, and Multiterritorial Extent of Subclinical Atherosclerosis in a Middle-Aged Cohort: The PESA (Progression of Early Subclinical Atherosclerosis) Study
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 a...
| Autores: | , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Tipo de documento: | artigo |
| Data de publicação: | 2015 |
| País: | España |
| Recursos: | Instituto de Salud Carlos III (ISCIII) |
| Repositório: | Repisalud |
| Idioma: | inglês |
| OAI Identifier: | oai:repisalud.isciii.es:20.500.12105/8352 |
| Acesso em linha: | http://hdl.handle.net/20.500.12105/8352 |
| Access Level: | Acceso aberto |
| Palavra-chave: | Adult Age Factors Ankle Brachial Index Aorta, Abdominal Aortic Diseases Aortography Asymptomatic Diseases Atherosclerosis Calcinosis Carotid Artery Diseases Comorbidity Coronary Angiography Coronary Artery Disease Disease Progression Female Femoral Artery Follow-Up Studies Humans Iliac Artery Male Middle Aged Multidetector Computed Tomography Plaque, Atherosclerotic Prevalence Prospective Studies Risk Factors Spain Ultrasonography |
| id |
ES_a91c6721e7b1f8d6a2c1ee2ebdc15cc5 |
|---|---|
| oai_identifier_str |
oai:repisalud.isciii.es:20.500.12105/8352 |
| network_acronym_str |
ES |
| network_name_str |
España |
| repository_id_str |
|
| spelling |
Prevalence, Vascular Distribution, and Multiterritorial Extent of Subclinical Atherosclerosis in a Middle-Aged Cohort: The PESA (Progression of Early Subclinical Atherosclerosis) StudyFernandez-Friera, LeticiaPeñalvo, Jose LFernandez-Ortiz, AntonioIbáñez, BorjaLopez-Melgar, BeatrizLaclaustra, MartinOliva, BelenMocoroa, AgustínMendiguren, Jose MMartínez de Vega, VicenteGarcia, LauraMolina, JesusSanchez-Gonzalez, JavierGuzman-Martinez, GabrielaAlonso-Farto, Juan CGuallar, EliseoCiveira, FernandoSillesen, HenrikPocock, StuartOrdovas, Jose MSanz, GinesJimenez-Borreguero, Luis J.Fuster, ValentinAdultAge FactorsAnkle Brachial IndexAorta, AbdominalAortic DiseasesAortographyAsymptomatic DiseasesAtherosclerosisCalcinosisCarotid Artery DiseasesComorbidityCoronary AngiographyCoronary Artery DiseaseDisease ProgressionFemaleFemoral ArteryFollow-Up StudiesHumansIliac ArteryMaleMiddle AgedMultidetector Computed TomographyPlaque, AtheroscleroticPrevalenceProspective StudiesRisk FactorsSpainUltrasonographyBACKGROUND: 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. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01410318.American Heart Association (AHA)Centro Nacional de Investigaciones Cardiovasculares Carlos III (España)Banco SantanderMinisterio de Economía y Competitividad (España)Fundación ProCNIC20192019-09-1620152015-06-1620152015-06-16journal articlehttp://purl.org/coar/resource_type/c_6501AMhttp://purl.org/coar/version/c_ab4af688f83e57aainfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/20.500.12105/8352reponame:Repisaludinstname:Instituto de Salud Carlos III (ISCIII)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Atribución-NoComercial-CompartirIgual 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-sa/4.0/info:eu-repo/semantics/openAccessoai:repisalud.isciii.es:20.500.12105/83522026-06-12T12:43:37Z |
| dc.title.none.fl_str_mv |
Prevalence, Vascular Distribution, and Multiterritorial Extent of Subclinical Atherosclerosis in a Middle-Aged Cohort: The PESA (Progression of Early Subclinical Atherosclerosis) Study |
| title |
Prevalence, Vascular Distribution, and Multiterritorial Extent of Subclinical Atherosclerosis in a Middle-Aged Cohort: The PESA (Progression of Early Subclinical Atherosclerosis) Study |
| spellingShingle |
Prevalence, Vascular Distribution, and Multiterritorial Extent of Subclinical Atherosclerosis in a Middle-Aged Cohort: The PESA (Progression of Early Subclinical Atherosclerosis) Study Fernandez-Friera, Leticia Adult Age Factors Ankle Brachial Index Aorta, Abdominal Aortic Diseases Aortography Asymptomatic Diseases Atherosclerosis Calcinosis Carotid Artery Diseases Comorbidity Coronary Angiography Coronary Artery Disease Disease Progression Female Femoral Artery Follow-Up Studies Humans Iliac Artery Male Middle Aged Multidetector Computed Tomography Plaque, Atherosclerotic Prevalence Prospective Studies Risk Factors Spain Ultrasonography |
| title_short |
Prevalence, Vascular Distribution, and Multiterritorial Extent of Subclinical Atherosclerosis in a Middle-Aged Cohort: The PESA (Progression of Early Subclinical Atherosclerosis) Study |
| title_full |
Prevalence, Vascular Distribution, and Multiterritorial Extent of Subclinical Atherosclerosis in a Middle-Aged Cohort: The PESA (Progression of Early Subclinical Atherosclerosis) Study |
| title_fullStr |
Prevalence, Vascular Distribution, and Multiterritorial Extent of Subclinical Atherosclerosis in a Middle-Aged Cohort: The PESA (Progression of Early Subclinical Atherosclerosis) Study |
| title_full_unstemmed |
Prevalence, Vascular Distribution, and Multiterritorial Extent of Subclinical Atherosclerosis in a Middle-Aged Cohort: The PESA (Progression of Early Subclinical Atherosclerosis) Study |
| title_sort |
Prevalence, Vascular Distribution, and Multiterritorial Extent of Subclinical Atherosclerosis in a Middle-Aged Cohort: The PESA (Progression of Early Subclinical Atherosclerosis) Study |
| dc.creator.none.fl_str_mv |
Fernandez-Friera, Leticia Peñalvo, Jose L Fernandez-Ortiz, Antonio Ibáñez, Borja Lopez-Melgar, Beatriz Laclaustra, Martin Oliva, Belen Mocoroa, Agustín Mendiguren, Jose M Martínez de Vega, Vicente Garcia, Laura Molina, Jesus Sanchez-Gonzalez, Javier Guzman-Martinez, Gabriela Alonso-Farto, Juan C Guallar, Eliseo Civeira, Fernando Sillesen, Henrik Pocock, Stuart Ordovas, Jose M Sanz, Gines Jimenez-Borreguero, Luis J. Fuster, Valentin |
| author |
Fernandez-Friera, Leticia |
| author_facet |
Fernandez-Friera, Leticia Peñalvo, Jose L Fernandez-Ortiz, Antonio Ibáñez, Borja Lopez-Melgar, Beatriz Laclaustra, Martin Oliva, Belen Mocoroa, Agustín Mendiguren, Jose M Martínez de Vega, Vicente Garcia, Laura Molina, Jesus Sanchez-Gonzalez, Javier Guzman-Martinez, Gabriela Alonso-Farto, Juan C Guallar, Eliseo Civeira, Fernando Sillesen, Henrik Pocock, Stuart Ordovas, Jose M Sanz, Gines Jimenez-Borreguero, Luis J. Fuster, Valentin |
| author_role |
author |
| author2 |
Peñalvo, Jose L Fernandez-Ortiz, Antonio Ibáñez, Borja Lopez-Melgar, Beatriz Laclaustra, Martin Oliva, Belen Mocoroa, Agustín Mendiguren, Jose M Martínez de Vega, Vicente Garcia, Laura Molina, Jesus Sanchez-Gonzalez, Javier Guzman-Martinez, Gabriela Alonso-Farto, Juan C Guallar, Eliseo Civeira, Fernando Sillesen, Henrik Pocock, Stuart Ordovas, Jose M Sanz, Gines Jimenez-Borreguero, Luis J. Fuster, Valentin |
| author2_role |
author author author author author author author author author author author author author author author author author author author author author author |
| dc.contributor.none.fl_str_mv |
Centro Nacional de Investigaciones Cardiovasculares Carlos III (España) Banco Santander Ministerio de Economía y Competitividad (España) Fundación ProCNIC |
| dc.subject.none.fl_str_mv |
Adult Age Factors Ankle Brachial Index Aorta, Abdominal Aortic Diseases Aortography Asymptomatic Diseases Atherosclerosis Calcinosis Carotid Artery Diseases Comorbidity Coronary Angiography Coronary Artery Disease Disease Progression Female Femoral Artery Follow-Up Studies Humans Iliac Artery Male Middle Aged Multidetector Computed Tomography Plaque, Atherosclerotic Prevalence Prospective Studies Risk Factors Spain Ultrasonography |
| topic |
Adult Age Factors Ankle Brachial Index Aorta, Abdominal Aortic Diseases Aortography Asymptomatic Diseases Atherosclerosis Calcinosis Carotid Artery Diseases Comorbidity Coronary Angiography Coronary Artery Disease Disease Progression Female Femoral Artery Follow-Up Studies Humans Iliac Artery Male Middle Aged Multidetector Computed Tomography Plaque, Atherosclerotic Prevalence Prospective Studies Risk Factors Spain Ultrasonography |
| description |
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. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01410318. |
| publishDate |
2015 |
| dc.date.none.fl_str_mv |
2015 2015-06-16 2015 2015-06-16 2019 2019-09-16 |
| dc.type.none.fl_str_mv |
journal article http://purl.org/coar/resource_type/c_6501 AM http://purl.org/coar/version/c_ab4af688f83e57aa |
| dc.type.openaire.fl_str_mv |
info:eu-repo/semantics/article |
| format |
article |
| dc.identifier.none.fl_str_mv |
http://hdl.handle.net/20.500.12105/8352 |
| url |
http://hdl.handle.net/20.500.12105/8352 |
| dc.language.none.fl_str_mv |
Inglés eng |
| language_invalid_str_mv |
Inglés |
| language |
eng |
| dc.rights.none.fl_str_mv |
open access http://purl.org/coar/access_right/c_abf2 Atribución-NoComercial-CompartirIgual 4.0 Internacional http://creativecommons.org/licenses/by-nc-sa/4.0/ |
| dc.rights.openaire.fl_str_mv |
info:eu-repo/semantics/openAccess |
| rights_invalid_str_mv |
open access http://purl.org/coar/access_right/c_abf2 Atribución-NoComercial-CompartirIgual 4.0 Internacional http://creativecommons.org/licenses/by-nc-sa/4.0/ |
| eu_rights_str_mv |
openAccess |
| dc.format.none.fl_str_mv |
application/pdf |
| dc.publisher.none.fl_str_mv |
American Heart Association (AHA) |
| publisher.none.fl_str_mv |
American Heart Association (AHA) |
| dc.source.none.fl_str_mv |
reponame:Repisalud instname:Instituto de Salud Carlos III (ISCIII) |
| instname_str |
Instituto de Salud Carlos III (ISCIII) |
| reponame_str |
Repisalud |
| collection |
Repisalud |
| repository.name.fl_str_mv |
|
| repository.mail.fl_str_mv |
|
| _version_ |
1869415974684327936 |
| score |
15.811543 |