Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2026
Serum lipid profiles and the burden of polyvascular atherosclerosis: a cross-sectional CTA-based study in a Chinese cohort.
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Lu Jing, Lin Fa, Weng Jiadi, Lyu Jian, Zhang Lelin, Song Wenxiong, Zhu Bingcheng, Ma Miao, Xu Huiwen, Xue Jionghao, Liu Minghao, Zhang Yunxin, Chen Yu, Li Runting, Wang Ke, Liu Haiyang, Chen Xiaolin, Zhao Jizong, Liu Jie
Аннотация
BACKGROUND AND AIMS: Coexisting atherosclerosis across vascular territories is a critical facet of multimorbidity in aging populations and is associated with adverse outcomes, yet it often remains underdiagnosed. Early identification through noninvasive screening is needed, given that atherosclerosis frequently affects polyvascular beds simultaneously and current guidelines lack specific recommendations for detecting polyvascular disease.
METHODS AND RESULTS: We performed a subset analysis of a prospective registry (BHC-C, NCT05961748) enrolling 719 Chinese patients (mean age 62 ± 11; 32.8% female) who underwent one-stop cerebral and carotid combined coronary (CCC) CTA plus comprehensive lipid profiling. Coronary atherosclerosis was most prevalent (80.7%), followed by extracranial carotid (77.9%) and intracranial (63.1%) plaques. Moderate-to-severe stenosis (≥50% luminal narrowing) was detected in 43.1%, 27.0%, and 26.6% of coronary, extracranial, and intracranial arteries, respectively. Notably, 11.8% of patients had triple-vessel coronary disease, and 8.7% exhibited concurrent intracranial, extracranial, and coronary involvement. Patients with polyvascular disease paradoxically showed lower LDL-C and Lp-PLA2 levels on average. This inverse cross-sectional association should be interpreted cautiously and may reflect prior ASCVD, intensive lipid-lowering or other preventive therapy, advanced disease stage, and residual confounding rather than a protective causal effect of lower Lp-PLA2.
CONCLUSIONS: CCC CTA plus lipid panel evaluation may help reveal occult polyvascular atherosclerosis. This approach enabled comprehensive visualization of multi-bed plaques alongside risk factor assessment, demonstrating potential to improve early detection and holistic management of CCC comorbidity in both primary and secondary prevention settings.
TRIAL REGISTRATION: ClinicalTrials.gov ID NCT05961748. Date of registration: 2023-09-21.
METHODS AND RESULTS: We performed a subset analysis of a prospective registry (BHC-C, NCT05961748) enrolling 719 Chinese patients (mean age 62 ± 11; 32.8% female) who underwent one-stop cerebral and carotid combined coronary (CCC) CTA plus comprehensive lipid profiling. Coronary atherosclerosis was most prevalent (80.7%), followed by extracranial carotid (77.9%) and intracranial (63.1%) plaques. Moderate-to-severe stenosis (≥50% luminal narrowing) was detected in 43.1%, 27.0%, and 26.6% of coronary, extracranial, and intracranial arteries, respectively. Notably, 11.8% of patients had triple-vessel coronary disease, and 8.7% exhibited concurrent intracranial, extracranial, and coronary involvement. Patients with polyvascular disease paradoxically showed lower LDL-C and Lp-PLA2 levels on average. This inverse cross-sectional association should be interpreted cautiously and may reflect prior ASCVD, intensive lipid-lowering or other preventive therapy, advanced disease stage, and residual confounding rather than a protective causal effect of lower Lp-PLA2.
CONCLUSIONS: CCC CTA plus lipid panel evaluation may help reveal occult polyvascular atherosclerosis. This approach enabled comprehensive visualization of multi-bed plaques alongside risk factor assessment, demonstrating potential to improve early detection and holistic management of CCC comorbidity in both primary and secondary prevention settings.
TRIAL REGISTRATION: ClinicalTrials.gov ID NCT05961748. Date of registration: 2023-09-21.
Предметные рубрики MeSH
HumansFemaleCross-Sectional StudiesMiddle AgedMaleAgedBiomarkersCoronary Artery DiseasePredictive Value of TestsComputed Tomography AngiographyChinaPrevalenceRisk FactorsCoronary AngiographyRegistriesIntracranial ArteriosclerosisCarotid Artery DiseasesPlaque, AtheroscleroticLipidsCerebral AngiographySeverity of Illness IndexProspective StudiesCarotid StenosisDyslipidemiasComorbidityEast Asian PeopleLipoprotein(a)