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dc.contributor.authorLopez-Melgar, Beatriz 
dc.contributor.authorFernandez-Friera, Leticia 
dc.contributor.authorOliva, Belen 
dc.contributor.authorGarcia-Ruiz, Jose M 
dc.contributor.authorSanchez-Cabo, Fatima 
dc.contributor.authorBueno, Héctor 
dc.contributor.authorMendiguren, Jose M
dc.contributor.authorLara-Pezzi, Enrique 
dc.contributor.authorAndres, Vicente 
dc.contributor.authorIbanez, Borja 
dc.contributor.authorFernandez-Ortiz, Antonio 
dc.contributor.authorSanz, Javier 
dc.contributor.authorFuster, Valentin
dc.identifier.citationJ Am Coll Cardiol. 2020; 75(14):1617-1627es_ES
dc.description.abstractAtherosclerosis progression predicts cardiovascular events; however, progression of multiterritorial subclinical atherosclerosis is incompletely understood. This study sought to study short-term progression of atherosclerosis using different noninvasive imaging techniques and their relationship with cardiovascular risk. The study included 3,514 PESA (Progression of Early Subclinical Atherosclerosis) study participants (45.7 ± 4.2 years of age; 63% men). Participants underwent 2-dimensional vascular ultrasound (2DVUS) of abdominal aorta, carotid, iliac, and femoral territories to determine a plaque number score; 3DVUS to quantify carotid and femoral plaque volume; and coronary artery calcium score (CACS) at baseline and 2.8 years later. The authors calculated the rate of new disease incidence and changes in disease extent. Logistic regression models were used to evaluate associations of progression rates with baseline cardiovascular risk factors and estimated 10-year risk. Imaging detected short-term (3-year) atherosclerosis progression in 41.5% of participants (26.4% by 2DVUS, 21.3% by 3DVUS, and 11.5% by CACS), particularly in peripheral territories examined by vascular ultrasound. New atherosclerosis onset accounted for approximately one-third of total progression, also more frequently by 2DVUS and 3DVUS (29.1% and 16.6%, respectively), than by CACS (2.9%). Participants with baseline disease by all 3 modalities (n = 432) also showed significant atherosclerosis progression (median: 1 plaque [interquartile range (IQR): -1 to 3 plaques] by 2DVUS; 7.6 mm3 [IQR: -32.2 to 57.6 mm3] by 3DVUS; and 21.6 Agatston units [IQR: 4.8 to 62.6 Agatston units] by CACS). Age, sex, dyslipidemia, hypertension, smoking, and family history of premature cardiovascular disease contributed to progression, with dyslipidemia the strongest modifiable risk factor. Although disease progression correlated with cardiovascular risk, progression was detected in 36.5% of participants categorized as low risk. With this multimodal and multiterritorial approach, the authors detected short-term progression of early subclinical atherosclerosis in a substantial proportion (41.5%) of apparently healthy middle-aged men and women, more frequently by peripheral 2D/3DVUS than by CACS. Disease progression, as defined in this study, correlated with almost all cardiovascular risk factors and estimated risk. (Progression of Early Subclinical Atherosclerosis [PESA]; NCT01410318).es_ES
dc.description.sponsorshipThe PESA-CNIC-Santander study is funded by the Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain, and Banco Santander, Madrid, Spain. The study also receives funding from the Instituto de Salud Carlos III (ISC III) (PI15/02019) and the European Regional Development Fund (ERDF) “Una manera de hacer Europa.” The CNIC is supported by the Ministerio de Ciencia e Innovación, the ISC III and the Pro CNIC Foundation, and is a Severo Ochoa Center of Excellence (SEV-2015-0505). Dr. Bueno has received research funding from the Instituto de Salud Carlos III, Spain (PIE16/00021 & PI17/01799); has received research funding from AstraZeneca, Bristol-Myers Squibb, and Novartis; has received consulting fees from AstraZeneca, Bayer, Bristol-Myers Squibb–Pfizer, and Novartis; and has received speaker fees or support for attending scientific meetings from Amgen, AstraZeneca, Bayer, Bristol-Myers Squibb–Pfizer, Novartis, and MEDSCAPE–the
dc.relation.isversionofPublisher's versiones_ES
dc.titleShort-Term Progression of Multiterritorial Subclinical Atherosclerosis.es_ES
dc.rights.licenseAttribution-NonCommercial-NoDerivatives 4.0 Internacional*
dc.contributor.funderCentro Nacional de Investigaciones Cardiovasculares (CNIC)
dc.contributor.funderInstituto de Salud Carlos III - ISCIII
dc.contributor.funderBanco Santander
dc.contributor.funderEuropean Regional Development Fund (ERDF/FEDER)
dc.contributor.funderMinisterio de Ciencia e Innovación (España)
dc.contributor.funderFundación ProCNIC
dc.contributor.funderFundación AstraZeneca
dc.contributor.funderBayer Healthcare Pharmaceuticals-Bayer Pharma AG
dc.contributor.funderBristol-Myers Squibb
dc.contributor.funderNovartis Farmaceutica S.A.
dc.identifier.journalJournal of the American College of Cardiologyes_ES
dc.repisalud.orgCNICCNIC::Grupos de investigación::Laboratorio Traslacional para la Imagen y Terapia Cardiovasculares_ES
dc.repisalud.orgCNICCNIC::Grupos de investigación::Investigación Cardiovascular Traslacional Multidisciplinariaes_ES
dc.repisalud.orgCNICCNIC::Grupos de investigación::Imagen Cardiovascular y Estudios Poblacionaleses_ES
dc.repisalud.orgCNICCNIC::Grupos de investigación::Regulación Molecular de la Insuficiencia Cardiacaes_ES
dc.repisalud.orgCNICCNIC::Grupos de investigación::Fisiopatología Cardiovascular Molecular y Genéticaes_ES
dc.repisalud.orgCNICCNIC::Unidades técnicas::Bioinformáticaes_ES

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Attribution-NonCommercial-NoDerivatives 4.0 Internacional
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