2026-06-14T03:29:51Zhttps://repisalud.isciii.es/rest/oai/request

oai:repisalud.isciii.es:20.500.12105/83522024-09-27T08:46:39Zcom_20.500.12105_19604com_20.500.12105_2051col_20.500.12105_19605

00925njm 22002777a 4500 dc Fernandez-Friera, Leticia author Peñalvo, Jose L author Fernandez-Ortiz, Antonio author Ibáñez, Borja author Lopez-Melgar, Beatriz author Laclaustra, Martin author Oliva, Belen author Mocoroa, Agustín author Mendiguren, Jose M author Martínez de Vega, Vicente author Garcia, Laura author Molina, Jesus author Sanchez-Gonzalez, Javier author Guzman-Martinez, Gabriela author Alonso-Farto, Juan C author Guallar, Eliseo author Civeira, Fernando author Sillesen, Henrik author Pocock, Stuart author Ordovas, Jose M author Sanz, Gines author Jimenez-Borreguero, Luis J. author Fuster, Valentin author 2015-06-16 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. Circulation. 2015; 131(24):2104-13 10.1161/CIRCULATIONAHA.114.014310 1524-4539 0009-7322 Circulation 25882487 http://hdl.handle.net/20.500.12105/8352 Atherosclerosis Epidemiology Multidetector computed tomography Population Risk assessment Ultrasonography Prevalence, Vascular Distribution, and Multiterritorial Extent of Subclinical Atherosclerosis in a Middle-Aged Cohort: The PESA (Progression of Early Subclinical Atherosclerosis) Study