Association between multi-site atherosclerotic plaques and systemic arteriosclerosis: results from the BEST study (Beijing Vascular Disease Patients Evaluation Study)

Abstract

Background: Arteriosclerosis can be reflected in various aspect of the artery, including atherosclerotic plaque formation or stiffening on the arterial wall. Both arteriosclerosis and atherosclerosis are important and closely associated with cardiovascular disease (CVD). The aim of the study was to evaluate the association between systemic arteriosclerosis and multi-site atherosclerotic plaques.

Methods: The study was designed as an observational cross-sectional study. A total of 1178 participants (mean age 67.4 years; 52.2% male) enrolled into the observational study from 2010 to 2017. Systemic arteriosclerosis was assessed by carotid femoral artery pulse wave velocity (CF-PWV) and multi-site atherosclerotic plaques (MAP, > = 2 of the below sites) were reflected in the carotid or subclavian artery, abdominal aorta and lower extremities arteries using ultrasound equipment. The associations were assessed by multivariable logistic regression.

Results: The prevalence of CF-PWV > 12 m/s and MAP were 40.2% and 74.4%. Atherosclerotic plaques in 3 sites were more common in male compared with that in female (48.9% versus 36.9%, p < 0.05). All CVD factors were worse in participants with MAP than that with <=1 site. Participants with CF-PWV > 12 m/s corresponded to a mean 82% probability of MAP with age and sex-adjusted. Patients with peripheral artery disease showed the highest odds ratio (OR) (3.88) for MAP, followed by smoking (2.485), CF-PWV > 12 m/s (2.25), dyslipidemia (1.89), male (1.84), stroke (1.64), hypoglycemic agents (1.56) and age (1.09) (all p < 0.001).

Conclusions: MAP was highly prevalent in this cohort, with male showing a higher prevalence than female. Higher systemic arteriosclerosis was independently associated with MAP, which indicating the supplementary value of arteriosclerosis for the earlier identification and intervention on MAP.

Trial registration: Clinical Trial, URL: http://www.clinicaltrials.gov . Unique identifier: NCT02569268 .

Keywords: Arteriosclerosis; Atherosclerosis; Atherosclerotic plaque; CF-PWV; Carotid femoral artery pulse wave velocity.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1

a Presence of plaque in carotid artery. b Presence of plaque in subclavian artery. c Presence of plaque in abdominal aorta. d Presence of plaque in femoral artery

Fig. 2

a to d Prevalence and Distribution of Atherosclerotic Plaque in different vascular sites (in each single or combined vascular site) by ultrasonography, comparing male with female. Vascular sites examined were the right and left carotids and subclavian artery, the abdominal aorta, and the right and left lower extremities arteries (presence of plaque). a The distribution of the number of plaque site detected by vascular ultrasound, including presence of plaque in 0,1,2,3 of carotid artery, abdominal aorta, femoral artery, comparing male with female. b The distribution of plaque site in only one of carotid artery, femoral artery and abdominal aorta detected by vascular ultrasound, comparing male with female. c The distribution of plaque site in two of carotid artery, femoral artery and abdominal aorta detected by vascular ultrasound, comparing male with female. d The individual distribution of anyone territory plaque in carotid artery, femoral artery and abdominal aorta detected by vascular ultrasound, comparing male with female

Fig. 3

Age and sex-adjusted mean of predicted probability of multi-site atherosclerotic plaques (> = 2 sites) in each CF-PWV group, analyzed by age and sex-adjusted covariance analysis