Title : Subclinical atherosclerosis: Association with additional risk factors and somatic diseases
Abstract:
Atherosclerosis has a long preclinical phase and the risk of cardiovascular events may be high in patients in the asymptomatic stage of the disease (subclinical atherosclerosis, SA). The presence of classical risk factors increases the likelihood of developing cardiovascular events, but additional identification measures are required in patients with SA. In the adult population, subclinical atherosclerosis is detected on average in 50% of cases (depending on the location, it can vary from 30% to 70% of cases). Among people with low cardiovascular risk, SA is detected with a similar frequency, which is a limitation of integral prognostic scales. In the PESA study (n=4184, mean age 45.8 years; 63% men), among participants at low 10-year risk using the Framingham score, subclinical atherosclerosis was detected in 58% and intermediate or generalized disease in 36%.
A meta-analysis of publications in PubMed and Scopus from 2015 to 2024 was conducted using keywords: subclinical atherosclerosis, association with somatic diseases and additional risk factors. Among the somatic diseases associated with subclinical atherosclerosis are metabolic syndrome, progestational type 2 diabetes mellitus, fatty liver disease, psoriasis, antiphospholipid syndrome, arthritis and systemic lupus erythematosus.
Additional risk factors may also provide valuable information about the presence of asymptomatic atherosclerosis. A series of studies have demonstrated that SA markers are strongly associated with insulin resistance, glycated hemoglobin in nondiabetic individuals, growth differentiation factor-15, circulating proteins, cystatin C, and hearing loss measured by audiometry. The presence of these disorders may be the basis for a diagnostic search for SA.
Thus, some diseases associated with metabolic disorders, systemic inflammatory diseases of connective tissue and skin, as well as additional risk factors are closely related to SA. These circumstances should be taken into account when developing comprehensive preventive measures to prevent clinical manifestations and complications in people with SA.
Keywords: Subclinical Atherosclerosis, Somatic Diseases, Additional Risk Factors.
