Prevalence and Distribution of Atherosclerosis in a Low- to Intermediate-Risk Population

Assessment with Whole-Body MR Angiography

Matthew A. Lambert, Jonathan R. Weir-McCall, Marco Salsano, Stephen J. Gandy, Daniel Levin, Ian Cavin, Roberta Littleford, Jennifer A. MacFarlane, Shona Z. Matthew, Richard S. Nicholas, Allan D. Struthers, Frank Sullivan, Shelley A. Henderson, Richard D. White, Jill J. F. Belch, J. Graeme Houston (Lead / Corresponding author)

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Abstract

Purpose: To quantify the burden and distribution of asymptomatic atherosclerosis in a population with a low to intermediate risk of cardiovascular disease. Materials and Between June 2008 and February 2013, 1528 participants Methods: with 10-year risk of cardiovascular disease less than 20% were prospectively enrolled. They underwent whole-body magnetic resonance (MR) angiography at 3.0 T by using a two-injection, four-station acquisition technique. Thirty-one arterial segments were scored according to maximum stenosis. Scores were summed and normalized for the number of assessable arterial segments to provide a standardized atheroma score (SAS). Multiple linear regression was performed to assess effects of risk factors on atheroma burden. Results: A total of 1513 participants (577 [37.9%] men; median age, 53.5 years; range, 40–83 years) completed the study protocol. Among 46903 potentially analyzable segments, 46601 (99.4%) were interpretable. Among these, 2468 segments (5%) demonstrated stenoses, of which 1649 (3.5%) showed stenosis less than 50% and 484 (1.0%) showed stenosis greater than or equal to 50%. Vascular stenoses were distributed throughout the body with no localized distribution. Seven hundred forty-seven (49.4%) participants had at least one stenotic vessel, and 408 (27.0%) participants had multiple stenotic vessels. At multivariable linear regression, SAS correlated with age (B = 3.4; 95% confidence interval: 2.61, 4.20), heart rate (B = 1.23; 95% confidence interval: 0.51, 1.95), systolic blood pressure (B = 0.02; 95% confidence interval: 0.01, 0.03), smoking status (B = 0.79; 95% confidence interval: 0.44, 1.15), and socioeconomic status (B = 20.06; 95% confidence interval: 20.10, 20.02) (P , .01 for all). Conclusion: Whole-body MR angiography identifies early vascular disease at a population level. Although disease prevalence is low on a per-vessel level, vascular disease is common on a per-participant level, even in this low- to intermediate-risk cohort.

Original languageEnglish
Pages (from-to)795-804
Number of pages10
JournalRadiology
Volume287
Issue number3
Early online date1 May 2018
DOIs
Publication statusPublished - Jun 2018

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Magnetic Resonance Angiography
Atherosclerosis
Pathologic Constriction
Confidence Intervals
Atherosclerotic Plaques
Population
Vascular Diseases
Linear Models
Cardiovascular Diseases
Blood Pressure
Social Class
Blood Vessels
Heart Rate
Smoking
Injections

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Lambert, Matthew A. ; Weir-McCall, Jonathan R. ; Salsano, Marco ; Gandy, Stephen J. ; Levin, Daniel ; Cavin, Ian ; Littleford, Roberta ; MacFarlane, Jennifer A. ; Matthew, Shona Z. ; Nicholas, Richard S. ; Struthers, Allan D. ; Sullivan, Frank ; Henderson, Shelley A. ; White, Richard D. ; Belch, Jill J. F. ; Houston, J. Graeme. / Prevalence and Distribution of Atherosclerosis in a Low- to Intermediate-Risk Population : Assessment with Whole-Body MR Angiography. In: Radiology. 2018 ; Vol. 287, No. 3. pp. 795-804.
@article{70ecee6158994ba7a945870ce98b6b4b,
title = "Prevalence and Distribution of Atherosclerosis in a Low- to Intermediate-Risk Population: Assessment with Whole-Body MR Angiography",
abstract = "Purpose: To quantify the burden and distribution of asymptomatic atherosclerosis in a population with a low to intermediate risk of cardiovascular disease. Materials and Between June 2008 and February 2013, 1528 participants Methods: with 10-year risk of cardiovascular disease less than 20{\%} were prospectively enrolled. They underwent whole-body magnetic resonance (MR) angiography at 3.0 T by using a two-injection, four-station acquisition technique. Thirty-one arterial segments were scored according to maximum stenosis. Scores were summed and normalized for the number of assessable arterial segments to provide a standardized atheroma score (SAS). Multiple linear regression was performed to assess effects of risk factors on atheroma burden. Results: A total of 1513 participants (577 [37.9{\%}] men; median age, 53.5 years; range, 40–83 years) completed the study protocol. Among 46903 potentially analyzable segments, 46601 (99.4{\%}) were interpretable. Among these, 2468 segments (5{\%}) demonstrated stenoses, of which 1649 (3.5{\%}) showed stenosis less than 50{\%} and 484 (1.0{\%}) showed stenosis greater than or equal to 50{\%}. Vascular stenoses were distributed throughout the body with no localized distribution. Seven hundred forty-seven (49.4{\%}) participants had at least one stenotic vessel, and 408 (27.0{\%}) participants had multiple stenotic vessels. At multivariable linear regression, SAS correlated with age (B = 3.4; 95{\%} confidence interval: 2.61, 4.20), heart rate (B = 1.23; 95{\%} confidence interval: 0.51, 1.95), systolic blood pressure (B = 0.02; 95{\%} confidence interval: 0.01, 0.03), smoking status (B = 0.79; 95{\%} confidence interval: 0.44, 1.15), and socioeconomic status (B = 20.06; 95{\%} confidence interval: 20.10, 20.02) (P , .01 for all). Conclusion: Whole-body MR angiography identifies early vascular disease at a population level. Although disease prevalence is low on a per-vessel level, vascular disease is common on a per-participant level, even in this low- to intermediate-risk cohort.",
author = "Lambert, {Matthew A.} and Weir-McCall, {Jonathan R.} and Marco Salsano and Gandy, {Stephen J.} and Daniel Levin and Ian Cavin and Roberta Littleford and MacFarlane, {Jennifer A.} and Matthew, {Shona Z.} and Nicholas, {Richard S.} and Struthers, {Allan D.} and Frank Sullivan and Henderson, {Shelley A.} and White, {Richard D.} and Belch, {Jill J. F.} and Houston, {J. Graeme}",
note = "Supported by Chest Heart and Stroke Scotland and Souter Foundation. D.L. supported by Tenovus. J.R.W.M. supported by Wellcome Trust through the Scottish Translational Medicine and Therapeutics Initiative (WT 085664) in the form of a Clinical Research Fellowship.",
year = "2018",
month = "6",
doi = "10.1148/radiol.2018171609",
language = "English",
volume = "287",
pages = "795--804",
journal = "Radiology",
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publisher = "Radiological Society of North America",
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Lambert, MA, Weir-McCall, JR, Salsano, M, Gandy, SJ, Levin, D, Cavin, I, Littleford, R, MacFarlane, JA, Matthew, SZ, Nicholas, RS, Struthers, AD, Sullivan, F, Henderson, SA, White, RD, Belch, JJF & Houston, JG 2018, 'Prevalence and Distribution of Atherosclerosis in a Low- to Intermediate-Risk Population: Assessment with Whole-Body MR Angiography', Radiology, vol. 287, no. 3, pp. 795-804. https://doi.org/10.1148/radiol.2018171609

Prevalence and Distribution of Atherosclerosis in a Low- to Intermediate-Risk Population : Assessment with Whole-Body MR Angiography. / Lambert, Matthew A.; Weir-McCall, Jonathan R.; Salsano, Marco; Gandy, Stephen J.; Levin, Daniel; Cavin, Ian; Littleford, Roberta; MacFarlane, Jennifer A.; Matthew, Shona Z.; Nicholas, Richard S.; Struthers, Allan D.; Sullivan, Frank; Henderson, Shelley A.; White, Richard D.; Belch, Jill J. F.; Houston, J. Graeme (Lead / Corresponding author).

In: Radiology, Vol. 287, No. 3, 06.2018, p. 795-804.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prevalence and Distribution of Atherosclerosis in a Low- to Intermediate-Risk Population

T2 - Assessment with Whole-Body MR Angiography

AU - Lambert, Matthew A.

AU - Weir-McCall, Jonathan R.

AU - Salsano, Marco

AU - Gandy, Stephen J.

AU - Levin, Daniel

AU - Cavin, Ian

AU - Littleford, Roberta

AU - MacFarlane, Jennifer A.

AU - Matthew, Shona Z.

AU - Nicholas, Richard S.

AU - Struthers, Allan D.

AU - Sullivan, Frank

AU - Henderson, Shelley A.

AU - White, Richard D.

AU - Belch, Jill J. F.

AU - Houston, J. Graeme

N1 - Supported by Chest Heart and Stroke Scotland and Souter Foundation. D.L. supported by Tenovus. J.R.W.M. supported by Wellcome Trust through the Scottish Translational Medicine and Therapeutics Initiative (WT 085664) in the form of a Clinical Research Fellowship.

PY - 2018/6

Y1 - 2018/6

N2 - Purpose: To quantify the burden and distribution of asymptomatic atherosclerosis in a population with a low to intermediate risk of cardiovascular disease. Materials and Between June 2008 and February 2013, 1528 participants Methods: with 10-year risk of cardiovascular disease less than 20% were prospectively enrolled. They underwent whole-body magnetic resonance (MR) angiography at 3.0 T by using a two-injection, four-station acquisition technique. Thirty-one arterial segments were scored according to maximum stenosis. Scores were summed and normalized for the number of assessable arterial segments to provide a standardized atheroma score (SAS). Multiple linear regression was performed to assess effects of risk factors on atheroma burden. Results: A total of 1513 participants (577 [37.9%] men; median age, 53.5 years; range, 40–83 years) completed the study protocol. Among 46903 potentially analyzable segments, 46601 (99.4%) were interpretable. Among these, 2468 segments (5%) demonstrated stenoses, of which 1649 (3.5%) showed stenosis less than 50% and 484 (1.0%) showed stenosis greater than or equal to 50%. Vascular stenoses were distributed throughout the body with no localized distribution. Seven hundred forty-seven (49.4%) participants had at least one stenotic vessel, and 408 (27.0%) participants had multiple stenotic vessels. At multivariable linear regression, SAS correlated with age (B = 3.4; 95% confidence interval: 2.61, 4.20), heart rate (B = 1.23; 95% confidence interval: 0.51, 1.95), systolic blood pressure (B = 0.02; 95% confidence interval: 0.01, 0.03), smoking status (B = 0.79; 95% confidence interval: 0.44, 1.15), and socioeconomic status (B = 20.06; 95% confidence interval: 20.10, 20.02) (P , .01 for all). Conclusion: Whole-body MR angiography identifies early vascular disease at a population level. Although disease prevalence is low on a per-vessel level, vascular disease is common on a per-participant level, even in this low- to intermediate-risk cohort.

AB - Purpose: To quantify the burden and distribution of asymptomatic atherosclerosis in a population with a low to intermediate risk of cardiovascular disease. Materials and Between June 2008 and February 2013, 1528 participants Methods: with 10-year risk of cardiovascular disease less than 20% were prospectively enrolled. They underwent whole-body magnetic resonance (MR) angiography at 3.0 T by using a two-injection, four-station acquisition technique. Thirty-one arterial segments were scored according to maximum stenosis. Scores were summed and normalized for the number of assessable arterial segments to provide a standardized atheroma score (SAS). Multiple linear regression was performed to assess effects of risk factors on atheroma burden. Results: A total of 1513 participants (577 [37.9%] men; median age, 53.5 years; range, 40–83 years) completed the study protocol. Among 46903 potentially analyzable segments, 46601 (99.4%) were interpretable. Among these, 2468 segments (5%) demonstrated stenoses, of which 1649 (3.5%) showed stenosis less than 50% and 484 (1.0%) showed stenosis greater than or equal to 50%. Vascular stenoses were distributed throughout the body with no localized distribution. Seven hundred forty-seven (49.4%) participants had at least one stenotic vessel, and 408 (27.0%) participants had multiple stenotic vessels. At multivariable linear regression, SAS correlated with age (B = 3.4; 95% confidence interval: 2.61, 4.20), heart rate (B = 1.23; 95% confidence interval: 0.51, 1.95), systolic blood pressure (B = 0.02; 95% confidence interval: 0.01, 0.03), smoking status (B = 0.79; 95% confidence interval: 0.44, 1.15), and socioeconomic status (B = 20.06; 95% confidence interval: 20.10, 20.02) (P , .01 for all). Conclusion: Whole-body MR angiography identifies early vascular disease at a population level. Although disease prevalence is low on a per-vessel level, vascular disease is common on a per-participant level, even in this low- to intermediate-risk cohort.

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