Abstract:
BACKGROUND:Detection of subclinical atherosclerosis improves risk prediction beyond cardiovascular risk factors (CVRFs) and risk scores, but quantification of plaque burden may improve it further. Novel 3-dimensional vascular ultrasound (3DVUS) provides accurate volumetric quantification of plaque burden. OBJECTIVES:The authors evaluated associations between 3DVUS-based plaque burden and CVRFs and explored potential added value over simple plaque detection. METHODS:The authors included 3,860 (92.2%) PESA (Progression of Early Subclinical Atherosclerosis) study participants (age 45.8 ± 4.3 years; 63% men). Bilateral carotid and femoral territories were explored by 3DVUS to determine the number of plaques and territories affected, and to quantify global plaque burden defined as the sum of all plaque volumes. Linear regression and proportional odds models were used to evaluate associations of plaque burden with CVRFs and estimated 10-year cardiovascular risk. RESULTS:Plaque burden was higher in men (63.4 mm3 [interquartile range (IQR): 23.8 to 144.8 mm3] vs. 25.7 mm3 [IQR: 11.5 to 61.6 mm3] in women; p < 0.001), in the femoral territory (64 mm3 [IQR: 27.6 to 140.5 mm3] vs. 23.1 mm3 [IQR: 9.9 to 48.7 mm3] in the carotid territory; p < 0.001), and with increasing age (p < 0.001). Age, sex, smoking, and dyslipidemia were more strongly associated with femoral than with carotid disease burden, whereas hypertension and diabetes showed no territorial differences. Plaque burden was directly associated with estimated cardiovascular risk independently of the number of plaques or territories affected (p < 0.01). CONCLUSIONS:3DVUS quantifies higher plaque burden in men, in the femoral territory, and with increasing age during midlife. Plaque burden correlates strongly with CVRFs, especially at the femoral level, and reflects estimated cardiovascular risk more closely than plaque detection alone. (Progression of Early Subclinical Atherosclerosis [PESA] Study; NCT01410318).
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
López-Melgar B,Fernández-Friera L,Oliva B,García-Ruiz JM,Peñalvo JL,Gómez-Talavera S,Sánchez-González J,Mendiguren JM,Ibáñez B,Fernández-Ortiz A,Sanz J,Fuster Vdoi
10.1016/j.jacc.2017.05.033subject
Has Abstractpub_date
2017-07-18 00:00:00pages
301-313issue
3eissn
0735-1097issn
1558-3597pii
S0735-1097(17)37487-9journal_volume
70pub_type
杂志文章,多中心研究abstract:OBJECTIVES:This study sought to determine the relation between coronary calcification detected with ultrafast computed tomography and lumen narrowing defined with angiography and evaluated whether this relation is influenced by age and gender. BACKGROUND:Ultrafast computed tomography has been shown to be a sensitive m...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(94)00342-n
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abstract:BACKGROUND:Congenital heart defects are more frequent in offspring of mothers with overweight or obesity. However, associations between maternal overweight and obesity, and risks of complex and specific heart defects are not clear. OBJECTIVES:This study sought to analyze associations between maternal overweight and ob...
journal_title:Journal of the American College of Cardiology
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journal_title:Journal of the American College of Cardiology
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更新日期:2002-08-21 00:00:00
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journal_title:Journal of the American College of Cardiology
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doi:10.1016/0735-1097(94)90612-2
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abstract::The St. Jude valve is a new bileaflet disc cardiac valve prosthesis designed to avoid some of the hemodynamic drawbacks of other prostheses. The in vivo flow characteristics of the St. Jude aortic valve (42 patients) were studied and compared with those of three other commonly used aortic prostheses. Björk-Shiley (12 ...
journal_title:Journal of the American College of Cardiology
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doi:10.1016/s0735-1097(84)80015-7
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journal_title:Journal of the American College of Cardiology
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journal_title:Journal of the American College of Cardiology
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更新日期:2018-04-03 00:00:00
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更新日期:2010-02-16 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:2013-12-03 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:2005-11-15 00:00:00
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更新日期:2009-08-11 00:00:00
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更新日期:2013-04-23 00:00:00
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journal_title:Journal of the American College of Cardiology
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journal_title:Journal of the American College of Cardiology
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2006-11-07 00:00:00
abstract:BACKGROUND:A limitation of aspirin is that some patients, particularly those with diabetes, may not have an optimal antiplatelet effect. OBJECTIVES:The goal of this study was to determine if oral bioavailability mediates nonresponsiveness. METHODS:The rate and extent of serum thromboxane generation and aspirin pharma...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,随机对照试验
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更新日期:2017-02-14 00:00:00
abstract:OBJECTIVES:The purpose of this study was to test the hypothesis that activated monocytes with soluble plasma tissue factor (pTF) activate factors VII and X to generate thrombin. BACKGROUND:Despite heparin, thrombin is progressively generated during cardiac surgery with cardiopulmonary bypass (CPB), produces intravascu...
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更新日期:2005-08-16 00:00:00