Subclinical atherosclerosis in young adults predicting cardiovascular disease : The cardiovascular risk in young Finns study

: Raitakari Olli T., Magnussen Costan G., Juonala Markus, Kartiosuo Noora, Pahkala Katja, Rovio Suvi, Koskinen Juhani S., Mykkänen Juha, Laitinen Tomi P., Kähönen Mika, Nuotio Joel, Viikari Jorma S.A.

Publisher: Elsevier

: 2024

: Atherosclerosis

: 117515

: 393

: 0021-9150

: 1879-1484

DOI: https://doi.org/10.1016/j.atherosclerosis.2024.117515

: https://doi.org/10.1016/j.atherosclerosis.2024.117515

: https://research.utu.fi/converis/portal/detail/Publication/387397580

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.

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The Young Finns Study has been financially supported by the Academy of Finland: grants 356405, 322098, 286284, 134309(Eye), 126925, 121584, 124282, 129378(Salve), 117797(Gendi), and 141071(Skidi); the Social Insurance Institution of Finland; Competitive State Research Financing of the Expert Responsibility area of Kuopio, Tampere and Turku University Hospitals (grant X51001); Juho Vainio Foundation; Paavo Nurmi Foundation; Finnish Foundation for Cardiovascular Research; Finnish Cultural Foundation; The Sigrid Juselius Foundation; Tampere Tuberculosis Foundation; Emil Aaltonen Foundation; Yrjö Jahnsson Foundation; Signe and Ane Gyllenberg Foundation; Diabetes Research Foundation of Finnish Diabetes Association; EU Horizon 2020 (grant 755320for TAXINOMISIS and grant 848146for To Aition); European Research Council (grant 742927for MULTIEPIGEN project); Tampere University Hospital Supporting Foundation; Finnish Society of Clinical Chemistry; the Cancer Foundation Finland; pBETTER4U_EU (Preventing obesity through Biologically and bEhaviorally Tailored inTERventions for you; project number: 101080117); and the Jane and Aatos Erkko Foundation.