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Asymptomatic polyvascular disease and the risks of cardiovascular events and all-cause death

  • Author Footnotes
    1 These authors contributed equally to this work.
    Qian Zhang
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    China National Clinical Research Center for Neurological Diseases, China

    Center of Stroke, Beijing Institute for Brain Disorders, China

    Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China
    Search for articles by this author
  • Author Footnotes
    1 These authors contributed equally to this work.
    Anxin Wang
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    China National Clinical Research Center for Neurological Diseases, China

    Center of Stroke, Beijing Institute for Brain Disorders, China

    Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China
    Search for articles by this author
  • Shufeng Zhang
    Affiliations
    Department of Neurology, The General Hospital of Chinese People's Armed Police Forces, Beijing, China
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  • Na Li
    Affiliations
    Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    China National Clinical Research Center for Neurological Diseases, China

    Center of Stroke, Beijing Institute for Brain Disorders, China

    Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China
    Search for articles by this author
  • Shengyun Chen
    Affiliations
    Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    China National Clinical Research Center for Neurological Diseases, China

    Center of Stroke, Beijing Institute for Brain Disorders, China

    Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China
    Search for articles by this author
  • Yaqing Zhang
    Affiliations
    Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    China National Clinical Research Center for Neurological Diseases, China

    Center of Stroke, Beijing Institute for Brain Disorders, China

    Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China
    Search for articles by this author
  • Yong Zhou
    Correspondence
    Corresponding author. 100029 Beijing, China.
    Affiliations
    Beijing Anzhen Hospital, Capital Medical University and Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China
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  • Shouling Wu
    Correspondence
    Corresponding author. 063000 Tangshan, China.
    Affiliations
    Department of Cardiology, Kailuan Hospital, Tangshan, China
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  • Xingquan Zhao
    Correspondence
    Corresponding author. No.6 Tiantanxili, Dongcheng District, 100050 Beijing, China.
    Affiliations
    Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    China National Clinical Research Center for Neurological Diseases, China

    Center of Stroke, Beijing Institute for Brain Disorders, China

    Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China
    Search for articles by this author
  • Author Footnotes
    1 These authors contributed equally to this work.

      Highlights

      • Polyvascular disease (PolyVD) was found in 3.03% participants, significantly higher in men (4.27%).
      • Patients with polyVD were older with more atherosclerosis risk factors.
      • Asymptomatic polyVD increased risks of cardiovascular events and all-cause death.

      Abstract

      Background and aims

      Atherosclerosis is a diffuse and systemic disease. We aimed to assess prevalence and outcome of extracoronary polyvascular disease (polyVD) in the asymptomatic Chinese community population.

      Methods

      A random sample of 5440 participants aged 40 years or older were enrolled in the Asymptomatic Polyvascular Abnormalities Community Study from 2010 to 2011. Intracranial artery stenosis, extracranial artery stenosis, and lower extremity artery disease were detected by transcranial Doppler and duplex sonography, and by calculating the ankle brachial index. The study endpoints included the first occurrence of stroke, myocardial infarction (MI) and all-cause death.

      Results

      PolyVD (two or three affected vascular territories) was found in 3.0% of the participants, and was significantly higher in men (4.3%). Over a median follow-up of 4.1 years, we identified a total of 247 events (4.7%), including 83 strokes (68 ischemic), 45 MIs and 134 all-cause deaths. After adjusting for age, gender and other potential confounders, we found a significant increase in risk of major cardiovascular events as well as all-cause death in participants with polyVD. In multivariate Cox regression analyses, the adjusted hazard ratios (HR) (95% confidence interval, CI) for the composite of stroke, MI and all-cause death for single and poly-vascular disease (compared with 0 vascular disease) increased from 1.58 (1.19–2.12) to 1.95 (1.26–3.03). Similarly, the adjusted HR (95% CI) for all-cause death for single and poly-vascular disease increased from 1.53 (1.03–2.29) to 2.22 (1.27–3.86).

      Conclusions

      PolyVD significantly increased the risk of major cardiovascular events and all-cause death in the asymptomatic community population. Performing invasive screening tests for polyVD is useful in the high-risk asymptomatic population.

      Keywords

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