title: Prevalence of coronary atherosclerosis in asymptomatic healthy subjects: an intravascular ultrasound study of donor hearts.
abstract: OBJECTIVE
  At present, limited in vivo information is available on the prevalence and severity of coronary atherosclerosis in asymptomatic healthy subjects. The aim of this study was to examine the prevalence, extent and severity of coronary atherosclerosis in healthy individuals.
  
  
  METHODS
  We performed an intravascular ultrasound (IVUS) examination on 198 heart transplant recipients 4 weeks after transplantation. The donor population consisted of 147 men and 51 women (31.4±11.0 years). The left anterior descending coronary artery was imaged in all patients, and 3 vessel images were obtained for 99 patients.
  
  
  RESULTS
  Angiographic appearance was completely normal in 177 of the 198 subjects (89.4%), while atherosclerotic luminal irregularities were observed in the remaining individuals. IVUS revealed that atherosclerotic lesions (defined as intimal thickness ≥0.5 mm at any site) were present in 96 patients (48.5%). The prevalence of coronary atherosclerosis rapidly increased with age (10-19 years, 5.9%; 20-29 years, 31.1%; 30-39 years, 59.0%; 40-49 years, 78.4%). In the diseased subgroup, atherosclerotic lesions were mostly eccentric (92.7%), with maximal intimal thickness of 0.99±0.42 mm (area stenosis, 32.2±11.7%). All coronary arteries were predominantly located in the proximal third of each vessel. Donor age, male sex, and hypertension were the determinants of coronary atherosclerosis measured by IVUS examination. As more risk factors were present, the risk of atherosclerosis increased.
  
  
  CONCLUSIONS
  Coronary atherosclerosis is common in asymptomatic young healthy adults, supporting the need for preventive cardiology in the early stages of life.
authors: Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Min-Seok
authors: MS
authors: Kim
authors: Soo-Jin
authors: SJ
authors: Kang
authors: Cheol-Whan
authors: CW
authors: Lee
authors: Seungbong
authors: S
authors: Han
authors: Duk-Woo
authors: DW
authors: Park
authors: Seung-Whan
authors: SW
authors: Lee
authors: Young-Hak
authors: YH
authors: Kim
authors: Seong-Wook
authors: SW
authors: Park
authors: Seung-Jung
authors: SJ
authors: Park
authors: Jae-Joong
authors: JJ
authors: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011859:Radiography; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D014019:Tissue Donors; D014463:Ultrasonography; D055815:Young Adult