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Serum lipid profiles and the burden of polyvascular atherosclerosis: a cross-sectional CTA-based study in a Chinese

Jing Lu1, Fa Lin2, Jiadi Weng2

  • 1Laboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; NMPA Key Laboratory for Quality Control of In Vitro Diagnostic, Beijing, China; Beijing Engineering Research Center of Immunological Reagents Clinical Research, Beijing, China.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|July 30, 2026
PubMed

Insights

Polyvascular atherosclerosis, affecting multiple vascular beds, is often underdiagnosed. Combined coronary, carotid, and cerebral computed tomography angiography (CCC CTA) with lipid profiling aids in early detection of this widespread disease.

Area of Science:

  • Cardiovascular Medicine
  • Radiology
  • Preventive Cardiology

Background:

  • Atherosclerosis commonly affects multiple vascular territories simultaneously, contributing to multimorbidity and adverse outcomes in aging populations.
  • Current guidelines lack specific recommendations for detecting polyvascular disease, leading to underdiagnosis.
  • Early, noninvasive screening is crucial for identifying widespread atherosclerosis.

Purpose of the Study:

  • To evaluate the utility of combined coronary, carotid, and cerebral computed tomography angiography (CCC CTA) with lipid profiling for detecting polyvascular atherosclerosis.
  • To assess the prevalence of atherosclerosis in coronary, extracranial carotid, and intracranial arteries.
  • To explore the relationship between polyvascular disease and lipid profiles.

Main Methods:

  • Subset analysis of a prospective registry (BHC-C, NCT05961748) including 719 Chinese patients.
  • Patients underwent one-stop CCC CTA and comprehensive lipid profiling.
  • Analysis included plaque prevalence, stenosis severity, and associations with lipid levels.

Main Results:

  • Coronary atherosclerosis was most prevalent (80.7%), followed by extracranial carotid (77.9%) and intracranial (63.1%) plaques.
  • Moderate-to-severe stenosis (≥50%) was found in 43.1% of coronary, 27.0% of extracranial carotid, and 26.6% of intracranial arteries.
  • Notably, 8.7% of patients had concurrent involvement of all three vascular beds; these patients paradoxically showed lower LDL-C and Lp-PLA2 levels.

Conclusions:

  • CCC CTA combined with lipid panel evaluation can help identify occult polyvascular atherosclerosis.
  • This integrated approach allows comprehensive visualization of multi-bed plaques and risk factor assessment.
  • The findings suggest potential for improved early detection and holistic management of polyvascular disease in primary and secondary prevention.
Abstract

Keywords:
ApoA-ICCC CTALipid biomarkersLp-PLA(2)Polyvascular atherosclerosis

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