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. 2022 Jun 1;5(6):e2218307.
doi: 10.1001/jamanetworkopen.2022.18307.

Prevalence and Vascular Distribution of Multiterritorial Atherosclerosis Among Community-Dwelling Adults in Southeast China

Yuesong Pan  1   2 , Jing Jing  1   2 , Xueli Cai  3 , Zening Jin  4 , Suying Wang  5 , Yilong Wang  1   2 , Chunlai Zeng  6 , Xia Meng  1   2 , Jiansong Ji  7 , Long Li  4   8 , Lingchun Lyu  6 , Zhe Zhang  1   2 , Lerong Mei  5 , Hao Li  1   2 , Shan Li  5 , Tiemin Wei  6 , Yongjun Wang  1   2   9   10   11
Affiliations

Prevalence and Vascular Distribution of Multiterritorial Atherosclerosis Among Community-Dwelling Adults in Southeast China

Yuesong Pan et al. JAMA Netw Open. .

Abstract

Importance: Data are limited on the prevalence and vascular distribution of multiterritorial atherosclerotic plaque and stenosis in community populations.

Objective: To investigate the prevalence and vascular distribution of multiterritorial atherosclerotic plaque and stenosis in older, community-dwelling populations in China.

Design, setting, and participants: This cross-sectional study was based on the baseline survey from the Polyvascular Evaluation for Cognitive Impairment and Vascular Events (PRECISE) study, a population-based prospective cohort study that enrolled community-dwelling adults aged 50 to 75 years based on cluster sampling from 6 villages and 4 living communities of Lishui city in southeast China. Data were collected from May 2017 to September 2019 and analyzed from September to November 2021.

Main outcomes and measures: Atherosclerotic plaque and stenosis at baseline were assessed in multiple vascular territories. Brain vessel wall magnetic resonance imaging (MRI) for intracranial and extracranial arteries; computed tomography angiography (CTA) for coronary, subclavian, aorta, renal, and iliofemoral arteries; and ankle-brachial index for peripheral arteries were performed at baseline survey. The extent of atherosclerosis was assessed according to the number of these 8 vascular sites affected, and polyvascular lesions were defined as at least 2 affected sites.

Results: A total of 3433 of 4202 invited individuals consented to participate in the study. After excluding 366 participants with contraindications for MRI or CTA scanning, with life expectancies of 4 years of fewer, or with mental disease, a total of 3067 community-dwelling adults were enrolled. The mean (SD) age was 61.2 (6.7) years; 1640 (53.5%) were women, and 74 (2.4%) had prevalent ASCVD. Most participants (2870 [93.6%]) had atherosclerotic plaques in at least 1 vascular territory. Atherosclerotic plaques were mostly detected in the aorta (2419 [79.6%]) and iliofemoral arteries (2312 [75.8%]), followed by subclavian (1500 [49.8%]), coronary (1366 [44.9%]), extracranial (1110 [36.4%]), renal (873 [28.7%]), and intracranial (542 [17.7%]) arteries. A substantial proportion of participants (1180 [38.5%]) had arterial stenosis of 50% or greater, predominantly affecting the coronary (542 [17.8%]) and iliofemoral (527 [17.3%]) arteries. Polyvascular atherosclerotic plaque was observed in 2541 participants (82.8%), with 1436 (46.8%) with plaque affecting 4 or more vascular territories, and polyvascular stenosis was observed in 412 patients (13.4%).

Conclusions and relevance: In this study, atherosclerotic plaque was highly prevalent in the older community population in China, and a substantial proportion of individuals reach stenosis of 50% or greater.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Yongjun Wang reported receiving grants from AstraZeneca during the conduct of the study. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. Prevalence and Vascular Distribution of Plaque and Arterial Stenosis
ABI indicates ankle-brachial index.
Figure 2.
Figure 2.. Burden of Multiterritorial Plaque and Arterial Stenosis by Age and Sex
See this image and copyright information in PMC

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