Association between subclinical atherosclerosis burden and unrecognized myocardial infarction detected by cardiac magnetic resonance in middle-aged low-risk adults
Authors' conclusion
In a low-risk middle-aged population, SA burden (CAC and peripheral plaques) was independently associated with a higher prevalence of IS identified by CMR.
Study context
- Population
- Asymptomatic middle-aged low-risk adults, PESA-CNIC-Santander study (median age 51 years, 84% male, median SCORE2 3.37)
- Participants
- 712 adults
- Exposure
- Subclinical atherosclerosis burden vs presence of ischaemic scar on cardiac magnetic resonance (CMR)
- Outcome
- Association between SA burden and ischaemic scar (subendocardial or transmural LGE) on CMR
Methodological detailsSubclinical atherosclerosis (SA) evaluated at enrolment and 3-year follow-up with 2D/3D vascular ultrasound (VUS) and coronary artery calcification scoring (CACS); CMR performed subsequently
- SA evaluated at enrolment and 3-year follow-up with 2D/3D VUS and CACS; CMR performed subsequently
Main finding
As reported in the abstract
Ischaemic scar on CMR
Odds ratio (95% CI)P value
High CACS (3rd tertile)
8.31(2.85–24.2)
P < 0.001High peripheral SA (number of plaques, 3rd tertile)
2.77(1.02–7.51)
P = 0.045- Positive late gadolinium enhancement (LGE) on CMR
- 132 (19.1%)
- Ischaemic scar identified
- 20 (2.9%)
Observational data: associations, not effects.
Further findings
Characteristics of individuals with ischaemic scar · baseline and 3-year follow-up
- Significantly higher baseline SCORE2, CACS and peripheral SA burden (plaque number by 2DVUS, plaque volume by 3DVUS) at both SA evaluations
Original publication
Association between subclinical atherosclerosis burden and unrecognized myocardial infarction detected by cardiac magnetic resonance in middle-aged low-risk adults. Eur Heart J Cardiovasc Imaging. Published 1 March 2024. doi:10.
Summarised from the published abstract; every number is checked against it