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dc.contributor.authorFernandez-Friera, Leticia 
dc.contributor.authorPenalvo, Jose L 
dc.contributor.authorFernandez-Ortiz, Antonio 
dc.contributor.authorIbanez, Borja 
dc.contributor.authorLopez-Melgar, Beatriz 
dc.contributor.authorLaclaustra, Martin 
dc.contributor.authorOliva, Belen 
dc.contributor.authorMocoroa, Agustín
dc.contributor.authorMendiguren, Jose M
dc.contributor.authorMartínez de Vega, Vicente
dc.contributor.authorGarcia, Laura 
dc.contributor.authorMolina, Jesus 
dc.contributor.authorSanchez-Gonzalez, Javier 
dc.contributor.authorGuzman-Martinez, Gabriela 
dc.contributor.authorAlonso-Farto, Juan C 
dc.contributor.authorGuallar, Eliseo 
dc.contributor.authorCiveira, Fernando
dc.contributor.authorSillesen, Henrik 
dc.contributor.authorPocock, Stuart 
dc.contributor.authorOrdovas, Jose M 
dc.contributor.authorSanz, Gines 
dc.contributor.authorJimenez-Borreguero, Luis J. 
dc.contributor.authorFuster, Valentin
dc.identifier.citationCirculation. 2015; 131(24):2104-13es_ES
dc.description.abstractBACKGROUND: 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: Unique identifier: NCT01410318.es_ES
dc.description.sponsorshipThis study was supported by a noncompetitive unrestricted grant shared equally between the CNIC and the Fundación Botín of Banco Santander. The PESA study is a noncommercial study that is independent of the healthcare and pharmaceutical industry. The CNIC is supported by the Spanish Ministry of Economy and Competitiveness and the Pro-CNIC Foundation.es_ES
dc.publisherAmerican Heart Associationes_ES
dc.subjectmultidetector computed tomographyes_ES
dc.subjectrisk assessmentes_ES
dc.subject.meshAdult es_ES
dc.subject.meshAge Factors es_ES
dc.subject.meshAnkle Brachial Index es_ES
dc.subject.meshAorta, Abdominal es_ES
dc.subject.meshAortic Diseases es_ES
dc.subject.meshAortography es_ES
dc.subject.meshAsymptomatic Diseases es_ES
dc.subject.meshAtherosclerosis es_ES
dc.subject.meshCalcinosis es_ES
dc.subject.meshCarotid Artery Diseases es_ES
dc.subject.meshComorbidity es_ES
dc.subject.meshCoronary Angiography es_ES
dc.subject.meshCoronary Artery Disease es_ES
dc.subject.meshDisease Progression es_ES
dc.subject.meshFemale es_ES
dc.subject.meshFemoral Artery es_ES
dc.subject.meshFollow-Up Studies es_ES
dc.subject.meshHumans es_ES
dc.subject.meshIliac Artery es_ES
dc.subject.meshMale es_ES
dc.subject.meshMiddle Aged es_ES
dc.subject.meshMultidetector Computed Tomography es_ES
dc.subject.meshPlaque, Atherosclerotices_ES
dc.subject.meshPrevalence es_ES
dc.subject.meshProspective Studies es_ES
dc.subject.meshRisk Factors es_ES
dc.subject.meshSpain es_ES
dc.subject.meshUltrasonography es_ES
dc.titlePrevalence, Vascular Distribution, and Multiterritorial Extent of Subclinical Atherosclerosis in a Middle-Aged Cohort: The PESA (Progression of Early Subclinical Atherosclerosis) Studyes_ES
dc.rights.licenseAtribución-NoComercial-CompartirIgual 4.0 Internacional*
dc.contributor.funderCentro Nacional de Investigaciones Cardiovasculares (CNIC)es_ES
dc.contributor.funderBanco Santanderes_ES
dc.contributor.funderMinisterio de Economía y Competitividad (España)es_ES
dc.contributor.funderFundación ProCNICes_ES
dc.repisalud.orgCNICCNIC::Grupos de investigación::Imagen Cardiovascular y Estudios Poblacionaleses_ES
dc.repisalud.orgCNICCNIC::Grupos de investigación::Laboratorio Traslacional para la Imagen y Terapia Cardiovasculares_ES

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Atribución-NoComercial-CompartirIgual 4.0 Internacional
This item is licensed under a: Atribución-NoComercial-CompartirIgual 4.0 Internacional