{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T20:21:37Z","timestamp":1790799697987,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T00:00:00Z","timestamp":1695600000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008084","name":"Neurof\u00f6rbundet","doi-asserted-by":"publisher","award":["F2020\u20100038"],"award-info":[{"award-number":["F2020\u20100038"]}],"id":[{"id":"10.13039\/501100008084","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012558","name":"Sk\u00e5ne County Council's Research and Development Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012558","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009389","name":"Stiftelsen Promobilia","doi-asserted-by":"publisher","award":["F18515"],"award-info":[{"award-number":["F18515"]}],"id":[{"id":"10.13039\/100009389","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011077","name":"Sk\u00e5nes universitetssjukhus","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011077","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cardiovascular disease is a major cause of death in people aging with spinal cord injury (SCI) and is predominantly caused by atherosclerosis; however, knowledge of atherosclerosis in people with SCI is scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe coronary and carotid atherosclerosis in middle\u2010aged people with long\u2010term cervical and upper thoracic SCI using coronary computed tomography angiography, carotid ultrasound, and cardiovascular disease risk factors and to compare with the general population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross\u2010sectional study with matched controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Outpatient SCI unit in southern Sweden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>\n                      Participants (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200925) in the Swedish SPinal Cord Injury Study on Cardiopulmonary and Autonomic Impairment (SPICA) (20% women, mean age 58\u2009years, mean time since injury 28\u2009years, injury levels C2\u2010T6, American Spinal Injury Association Impairment Scale A\u2010C). Non\u2010SCI controls (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009125; ratio 5:1) from the Swedish CArdioPulmonary bioImage Study (SCAPIS).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measurements<\/jats:title>\n                    <jats:p>Presence of coronary atherosclerosis, coronary artery calcium score, carotid plaques, carotid intima media thickness, blood pressure, lipids, Systematic Coronary Risk Evaluation (SCORE), and anthropometry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Coronary and carotid atherosclerotic plaques occurred in 44% of the participants, 67% of the controls exhibited coronary and 59% carotid plaques; odds ratios (OR; 95% confidence interval [CI]): 0.38 (0.13\u20131.17) and 0.54 (0.22\u20131.32), respectively. Mean number of segments with coronary atherosclerosis were 1.0 in participants and 2.1 in controls (OR: 0.74 [0.52\u20131.06]). Coronary artery calcium score\u2009&gt;\u2009100 occurred in 4 (18%) of the participants and 23 (21%) of the controls. The participants had significantly lower levels of total and non\u2010high density lipoprotein cholesterol and SCORE than the controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This is the first comprehensive assessment of atherosclerosis in people with SCI using advanced imaging techniques. The atherosclerotic burden in middle\u2010aged people with long\u2010term cervical and upper thoracic SCI was not increased, whereas SCORE was lower due to lower cholesterol levels. Imaging techniques may be valuable tools for assessment of atherosclerosis in SCI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pmrj.13043","type":"journal-article","created":{"date-parts":[[2023,7,26]],"date-time":"2023-07-26T04:59:50Z","timestamp":1690347590000},"page":"250-259","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Coronary and carotid imaging of atherosclerosis and contributing factors in middle\u2010aged people with long\u2010term cervical and upper thoracic spinal cord injuries"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1365-9483","authenticated-orcid":false,"given":"Mattias","family":"Hill","sequence":"first","affiliation":[{"name":"Department of Health Sciences Lund University  Lund Sweden"},{"name":"Department of Rehabilitation Medicine Sk\u00e5ne University Hospital  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"J\u00f6rgensen","sequence":"additional","affiliation":[{"name":"Department of Health Sciences Lund University  Lund Sweden"},{"name":"Department of Rehabilitation Medicine Sk\u00e5ne University Hospital  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunnar","family":"Engstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences in Malm\u00f6, Clinical Research Centre Lund University  Malm\u00f6 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaretha","family":"Persson","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences in Malm\u00f6, Clinical Research Centre Lund University  Malm\u00f6 Sweden"},{"name":"Department of Internal Medicine Sk\u00e5ne University Hospital  Malm\u00f6 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Lexell","sequence":"additional","affiliation":[{"name":"Department of Health Sciences Lund University  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,25]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2015.10.014"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3101729"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0021-9150(99)00479-7"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12384"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.121.055340"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3102045"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2009.02.035"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1310\/sci2404-379"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2018.06.008"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/PHM.0000000000001365"},{"key":"e_1_2_10_12_1","first-page":"1","article-title":"Functional and structural impairments of the pulmonary system in middle\u2010aged people with cervical and upper thoracic spinal cord injuries","author":"Hill M","year":"2022","journal-title":"J Spinal Cord Med"},{"key":"e_1_2_10_13_1","unstructured":"Strengthening the reporting of observational studies in epidemiology STROBE Statement. 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