![Quantification of Atherosclerotic Plaque Activity and Vascular Inflammation using [18-F] Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography FDG-PET/CT](/_next/image?url=https%3A%2F%2Fcloudfront.jove.com%2FCDNSource%2Fteasers%2F3777.jpg&w=3840&q=50)
Atherosclerotic Plaque in Patients with Zero Calcium Score at Coronary Computed Tomography Angiography
Fabíola Santos Gabriel1,2, Luiz Flávio Galvão Gonçalves3,2, Enaldo Vieira de Melo1
1Núcleo de Pós-Graduação em Medicina da Universidade Federal de Sergipe (UFS) - São Cristóvão, SE - Brazil.
Insights
A zero calcium score (CS) does not rule out coronary atherosclerotic plaques. This study found plaques in 9.3% of zero CS patients, with many being obstructive, particularly in non-obese alcohol drinkers.
Area of Science:
- Cardiology
- Radiology
- Preventive Medicine
Background:
- Cardiovascular diseases necessitate accurate risk stratification and diagnostic methods.
- A zero calcium score (CS) typically indicates low cardiovascular event risk.
- Literature presents conflicting data on the prevalence of coronary atherosclerotic plaques in individuals with a zero CS.
Purpose of the Study:
- To determine the frequency of coronary atherosclerotic plaques in patients with a zero CS undergoing coronary computed tomography angiography (CCTA).
- To assess the degree of obstruction and associated factors in these plaques.
- To identify patient characteristics linked to the presence of plaques despite a zero CS.
Main Methods:
- A cross-sectional, prospective study involving 367 volunteers with a zero CS on CCTA.
- Data collected from four diagnostic imaging centers between 2011 and 2016.
- Statistical analysis with a 5% significance level and 95% confidence interval.
Main Results:
- Atherosclerotic plaque was found in 9.3% (34 individuals) of the 367 patients with a zero CS.
- Among those with plaques, 47% had significant obstructions (>50%), and 25% involved two or more coronary segments.
- Non-obese individuals (90.6%) and alcohol drinkers (55.9%) were significantly more prevalent in the plaque group, with an odds ratio of 3.4 for each factor.
Conclusions:
- The presence of atherosclerotic plaque in patients with a zero CS is relatively common.
- A zero CS does not exclude the presence of coronary plaques, some of which are obstructive.
- Non-obese individuals and alcohol drinkers represent key subgroups where plaques may be present despite a zero CS.
Background:
In view of the high mortality for cardiovascular diseases, it has become necessary to stratify the main risk factors and to choose the correct diagnostic modality. Studies have demonstrated that a zero calcium score (CS) is characteristic of a low risk for cardiovascular events. However, the prevalence of individuals with coronary atherosclerotic plaques and zero CS is conflicting in the specialized literature.
Objective:
To evaluate the frequency of patients with coronary atherosclerotic plaques, their degree of obstruction and associated factors in patients with zero CS and indication for coronary computed tomography angiography (CCTA).
Methods:
This is a cross-sectional, prospective study with 367 volunteers with zero CS at CCTA in four diagnostic imaging centers in the period from 2011 to 2016. A significance level of 5% and 95% confidence interval were adopted.
Results:
The frequency of atherosclerotic plaque in the coronary arteries in 367 patients with zero CS was 9.3% (34 individuals). In this subgroup, mean age was 52 ± 10 years, 18 (52.9%) were women and 16 (47%) had significant coronary obstructions (> 50%), with involvement of two or more segments in 4 (25%) patients. The frequency of non-obese individuals (90.6% vs 73.9%, p = 0.037) and alcohol drinkers (55.9% vs 34.8%, p = 0.015) was significantly higher in patients with atherosclerotic plaques, with an odds ratio of 3.4 for each of this variable.
Conclusions:
The frequency of atherosclerotic plaque with zero CS was relatively high, indicating that the absence of calcification does not exclude the presence of plaques, many of which obstructive, especially in non-obese subjects and alcohol drinkers.
More Related Videos
Related Concept Videos
01:10Computed Tomography
The technique was invented in the 1970s and is based on the principle that as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates...
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:27Imaging Studies III: Computed Tomography
01:06Introduction to z Scores
z scores...
01:05Introduction to z Scores
z scores...
01:17z Scores and Area Under the Curve