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Prevalence, Vascular Distribution, and Multiterritorial Extent of Subclinical Atherosclerosis in a Middle-Aged Cohort: The PESA (Progression of Early Subclinical Atherosclerosis) Study
Open accessAbstract
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.
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Clonal hematopoiesis associated with TET2 deficiency accelerates atherosclerosis development in mice
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Self-citationFernández-Friera, L., Fuster, V., López-Melgar, B., Oliva, B., García-Ruiz, J. M., Mendiguren, J., Bueno, H., Pocock, S., Ibáñez, B., Fernández-Ortiz, A., et al. (2017) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.10.024 · Cited by 378
Self-citationTriglycerides and residual atherosclerotic risk
Raposeiras-Roubin, S., Rosselló, X., Oliva, B., Fernández-Friera, L., Mendiguren, J. M., Andrés, V., Bueno, H., Sanz, J., Martínez de Vega, V., Abu-Assi, E., et al. (2021) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2021.04.059 · Cited by 254
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Short-term progression of multiterritorial subclinical atherosclerosis
López-Melgar, B., Fernández-Friera, L., Oliva, B., García-Ruiz, J. M., Sánchez-Cabo, F., Bueno, H., Mendiguren, J. M., Lara-Pezzi, E., Andrés, V., Ibáñez, B., et al. (2020) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2020.02.026 · Cited by 103
Self-citationSubclinical atherosclerosis: how and when to treat it?
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Metadata
- Authors
- Fernández-Friera, L., Peñalvo, J. L., Fernández-Ortiz, A., Ibañez, B., López-Melgar, B., Laclaustra, M., Oliva, B., Mocoroa, A., Mendiguren, J., Martínez de Vega, V., García, L., Molina, J., Sánchez-González, J., Guzmán, G., Alonso-Farto, J. C., Guallar, E., Civeira, F., Sillesen, H., Pocock, S., Ordovás, J. M., Sanz, G., Jiménez-Borreguero, L. J., & Fuster, V.
- Venue
- Circulation
- Published
- 2015-06-16
- Volume
- 131
- Issue
- 24
- Pages
- 2104-2113
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2015124783
- Cited by
- 538
- References
- 4
- FWCI
- 25.65
- Type
- journal article
- Language
- en
- Open access
- green
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