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Arun Kadel1, Binay Kumar Rauniyar1, Sushant Kharel1

  • 1Department of Cardiology, Shahid Gangalal National Heart Center, Nepal.

Annales De Cardiologie Et D'Angeiologie
|May 24, 2024
PubMed
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A significant number of stable, symptomatic patients with zero coronary calcium score showed atherosclerotic plaque. Computed tomographic coronary angiography is recommended for these individuals to identify coronary artery disease.

Area of Science:

  • Cardiovascular Imaging
  • Radiology
  • Preventive Cardiology

Background:

  • Computed tomographic coronary angiography (CTCA) is reliable for excluding coronary artery disease (CAD) in intermediate-to-high risk patients.
  • Coronary calcium scoring (CCS) effectively excludes CAD in low-risk patients.
  • The study aimed to assess coronary atherosclerosis in symptomatic patients with a zero CCS using CTCA.

Purpose of the Study:

  • To determine the prevalence and extent of coronary atherosclerosis.
  • To evaluate the utility of CTCA in stable, symptomatic patients with a zero CCS.
  • To identify risk factors associated with plaque presence in this cohort.

Main Methods:

  • Retrospective analysis of 383 consecutive patients (age ≥ 18) with a zero CCS.
Keywords:
Angiographie coronarienne CTAthérosclérose coronarienneCT coronary angiographyChest painCoronary atherosclerosisCoronary calcium scoreDouleur thoraciqueNepalNépalScore de calcium coronarien

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  • Patients underwent CTCA for evaluation of coronary artery disease.
  • Demographic data, cardiovascular risk factors, and CTCA findings were analyzed.

    • Main Results:

    • 34 (8.9%) patients had detectable atherosclerotic plaque.
    • Hypertension (55.9%) and dyslipidemia (29.4%) were common in patients with plaque.
    • The left anterior descending artery was most frequently affected; 67.6% had non-obstructive plaque, and 32.3% had obstructive plaque.

    Conclusions:

    • Atherosclerotic plaque is present in a notable proportion of patients with a zero CCS.
    • CTCA is indicated for symptomatic patients with a low likelihood of CAD based on CCS.
    • Further investigation may refine risk stratification strategies in this population.