Subclinical atherosclerosis in young adults predicting cardiovascular disease: The Cardiovascular Risk in Young Finns Study

Atherosclerosis. 2024 Jun:393:117515. doi: 10.1016/j.atherosclerosis.2024.117515. Epub 2024 Mar 19.

Abstract

Background and aims: Atherosclerosis is accompanied by pre-clinical vascular changes that can be detected using ultrasound imaging. We examined the value of such pre-clinical features in identifying young adults who are at risk of developing atherosclerotic cardiovascular disease (ASCVD).

Methods: A total of 2641 individuals free of ASCVD were examined at the mean age of 32 years (range 24-45 years) for carotid artery intima-media thickness (IMT) and carotid plaques, carotid artery elasticity, and brachial artery flow-mediated endothelium-dependent vasodilation (FMD). The average follow-up time to event/censoring was 16 years (range 1-17 years).

Results: Sixty-seven individuals developed ASCVD (incidence 2.5%). The lowest incidence (1.1%) was observed among those who were estimated of having low risk according to the SCORE2 risk algorithm (<2.5% 10-year risk) and who did not have plaque or high IMT (upper decile). The highest incidence (11.0%) was among those who were estimated of having a high risk (≥2.5% 10-year risk) and had positive ultrasound scan for carotid plaque and/or high IMT (upper decile). Carotid plaque and high IMT remained independently associated with higher risk in multivariate models. The distributions of carotid elasticity indices and brachial FMD did not differ between cases and non-cases.

Conclusions: Screening for carotid plaque and high IMT in young adults may help identify individuals at high risk for future ASCVD.

Keywords: Cohort studies; Epidemiology; Pre-clinical atherosclerosis; Risk factors; Risk prediction; Vascular ultrasound.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Asymptomatic Diseases
  • Atherosclerosis* / diagnosis
  • Atherosclerosis* / diagnostic imaging
  • Atherosclerosis* / epidemiology
  • Atherosclerosis* / physiopathology
  • Brachial Artery* / diagnostic imaging
  • Brachial Artery* / physiopathology
  • Cardiovascular Diseases / epidemiology
  • Carotid Arteries / diagnostic imaging
  • Carotid Arteries / physiopathology
  • Carotid Artery Diseases* / diagnostic imaging
  • Carotid Artery Diseases* / epidemiology
  • Carotid Artery Diseases* / physiopathology
  • Carotid Intima-Media Thickness*
  • Elasticity
  • Female
  • Finland / epidemiology
  • Heart Disease Risk Factors
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Plaque, Atherosclerotic*
  • Predictive Value of Tests
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Vascular Stiffness
  • Vasodilation
  • Young Adult