Determinants of Progression and Regression of Subclinical Atherosclerosis Over 6 Years.
3D vascular ultrasound
LDL
blood pressure
progression
regression
risk factors
subclinical atherosclerosis
Journal
Journal of the American College of Cardiology
ISSN: 1558-3597
Titre abrégé: J Am Coll Cardiol
Pays: United States
ID NLM: 8301365
Informations de publication
Date de publication:
28 Nov 2023
28 Nov 2023
Historique:
received:
25
07
2023
revised:
13
09
2023
accepted:
22
09
2023
medline:
27
11
2023
pubmed:
23
11
2023
entrez:
22
11
2023
Statut:
ppublish
Résumé
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. 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. 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 (mm 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 (P 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).
Sections du résumé
BACKGROUND
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
OBJECTIVE
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
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 (mm
RESULTS
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 (P
CONCLUSIONS
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).
Identifiants
pubmed: 37993199
pii: S0735-1097(23)07629-5
doi: 10.1016/j.jacc.2023.09.814
pii:
doi:
Substances chimiques
Cholesterol, LDL
0
Banques de données
ClinicalTrials.gov
['NCT01410318']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2069-2083Informations de copyright
Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Funding Support and Author Disclosures The PESA study is funded by the National Center for Cardiovascular Investigations (CNIC) and Santander Bank. The CNIC is supported by the Carlos III Institute of Health (ISCIII), the Ministry of Science and Innovation, and the Pro CNIC Foundation. CNIC is a Severo Ochoa Center of Excellence (grant CEX2020-001041-S funded by MICIN/AEI/10.13039/501100011033). Dr Sánchez-González is an employee of Philips. Dr Ibáñez has received support from the European Commission (ERC-CoG 819775, and H2020-HEALTH 945118), the Spanish Ministry of Science and Innovation (PID2019-110369RB-I00), and the Community of Madrid (P2022/BMD-7403, RENIM-CM). Dr Mendieta was recipient of the 2020 “CardioJoven” Fellowship funded by the Spanish Society of Cardiology and the Centro Nacional de Investigaciones Cardiovasculares. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.