ArticleJournal of cardiovascular development and disease2026
Clinical-Metabolic Risk Phenotypes and Carotid Plaque Burden Among Community-Dwelling Individuals at High Cardiovascular Risk: An Exploratory Cross-Sectional Study.
Article in Journal of cardiovascular development and disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCommunity-dwelling individuals at high cardiovascular risk are clinically heterogeneous, but whether distinct clinical-metabolic phenotypes differ in carotid plaque burden remains unclear.
methodsFrom 4191 participants in a community-based screening project conducted in two communities in Guangzhou, 1015 individuals in the high-cardiovascular-risk stage with nonmissing high-plaque-burden status were included. All 1015 participants underwent exploratory clustering using 17 clinical, metabolic, lifestyle-related, and disease-history variables. High plaque burden was defined as bilateral carotid plaques, multiple plaques, or maximum plaque thickness at or above the 75th percentile among plaque-positive participants. Logistic regression examined associations between phenotypes and high plaque burden.
resultsAmong the 1015 participants included in the clustering analysis, 329 (32.4%) met the definition of high plaque burden. Four phenotypes were identified: relatively low metabolic burden, older age-ASCVD burden, smoking-low HDL-C, and blood pressure-loaded phenotypes. The corresponding prevalences of high plaque burden were 15.9%, 44.4%, 49.7%, and 33.2%. After adjustment for age and sex, all three non-reference phenotypes showed higher odds of high plaque burden. In sensitivity analysis excluding age and prior ASCVD from clustering, the blood pressure-loaded phenotype remained associated with high plaque burden.
conclusionsFour exploratory clinical-metabolic phenotypes showed different levels of carotid plaque burden among community-dwelling individuals at high cardiovascular risk. The blood pressure-loaded and smoking-low HDL-C phenotypes were associated with greater plaque burden and may provide an exploratory framework for describing heterogeneity within high-risk populations.
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