Por favor, use este identificador para citar o enlazar este Item:http://hdl.handle.net/20.500.12105/16850
Título
Determinants of Progression and Regression of Subclinical Atherosclerosis Over 6 Years.
Autor(es)
Mendieta, Guiomar | Pocock, Stuart CNIC | Mass, Virginia | Moreno, Andrea | Owen, Ruth | Garcia-Lunar, Ines CNIC | Lopez-Melgar, Beatriz CNIC | Fuster, Jose J. CNIC | Andres, Vicente CNIC | Pérez-Herreras, Cristina | Bueno, Hector CNIC | Fernandez-Ortiz, Antonio CNIC | Sanchez-Gonzalez, Javier CNIC | Garcia-Alvarez, Ana CNIC | Ibáñez, Borja CNIC | Fuster, Valentin CNIC
Fecha de publicación
2023-11-28
Cita
J Am Coll Cardiol. 2023 Nov 28;82(22):2069-2083.
Idioma
Inglés
Tipo de documento
journal article
Resumen
BACKGROUND
Atherosclerosis is a systemic disease that frequently begins early in life. However, knowledge about the temporal disease dynamics (ie, progression or regression) of human subclinical atherosclerosis and their determinants is scarce.
OBJECTIVES
This study sought to investigate early subclinical atherosclerosis disease dynamics within a cohort of middle-aged, asymptomatic individuals by using multiterritorial 3-dimensional vascular ultrasound (3DVUS) imaging.
METHODS
A total of 3,471 participants from the PESA (Progression of Early Subclinical Atherosclerosis) cohort study (baseline age 40-55 years; 36% female) underwent 3 serial 3DVUS imaging assessments of peripheral arteries at 3-year intervals. Subclinical atherosclerosis was quantified as global plaque volume (mm3) (bilateral carotid and femoral plaque burden). Multivariable logistic regression models for progression and regression were developed using stepwise forward variable selection.
RESULTS
Baseline to 6-year subclinical atherosclerosis progression occurred in 32.7% of the cohort (17.5% presenting with incident disease and 15.2% progressing from prevalent disease at enrollment). Regression was observed in 8.0% of those patients with baseline disease. The effects of higher low-density lipoprotein cholesterol (LDL-C) and elevated systolic blood pressure (SBP) on 6-year subclinical atherosclerosis progression risk were more pronounced among participants in the youngest age stratum (Pinteraction = 0.04 and 0.02, respectively).
CONCLUSIONS
Over 6 years, subclinical atherosclerosis progressed in one-third of middle-age asymptomatic subjects. Atherosclerosis regression is possible in early stages of the disease. The impact of LDL-C and SBP on subclinical atherosclerosis progression was more pronounced in younger participants, a finding suggesting that the prevention of atherosclerosis and its progression could be enhanced by tighter risk factor control at younger ages, with a likely long-term impact on reducing the risk of clinical events. (Progression of Early Subclinical Atherosclerosis [PESA; also PESA-CNIC-Santander]; NCT01410318).
MESH
Atherosclerosis | Plaque, Atherosclerotic | Middle Aged | Humans | Female | Adult | Male | Cohort Studies | Cholesterol, LDL | Disease Progression | Carotid Arteries | Risk Factors
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