title: Prevalence of noncalcified coronary plaques by 64-slice computed tomography in patients with an intermediate risk for significant coronary artery disease.
abstract: OBJECTIVE
  In this prospective study, we investigated the prevalence and characteristics of clearly discernible noncalcified coronary plaques in a patient population with suspected significant coronary artery disease (CAD) by using 64-slice computed tomography (CT).
  
  
  BACKGROUND
  The assessment of noncalcified coronary plaques by noninvasive strategies may be important to improve cardiovascular risk stratification.
  
  
  METHODS
  To rule out significant stenosis, high-resolution 64-slice coronary CT (0.6-mm collimation, 330-ms gantry rotation time) was performed in 161 consecutive patients with an intermediate risk for having CAD. Computed tomography data sets were evaluated for presence of coronary calcifications, noncalcified plaques, and/or lumen narrowing.
  
  
  RESULTS
  Noncalcified coronary plaques were detected in 48 (29.8%) of 161 enrolled patients. Although noncalcified plaques together with coronary calcifications were present in 38 of 161 (23.6%) patients, the prevalence of noncalcified plaques as the only manifestation of CAD was 6.2% (10 of 161 patients). Patients with noncalcified plaques were characterized by significantly higher total cholesterol, low-density lipoprotein, and C-reactive protein levels as well as a trend for more diabetes mellitus. The majority of noncalcified plaques resulted in lumen narrowing of <50%. Of the remaining 113 patients, CAD and coronary calcifications were ruled out in 53 of 161 (32.9%) patients, whereas 60 of 161 (37.3%) patients presented with calcifications in the absence of noncalcified plaque.
  
  
  CONCLUSIONS
  With the use of 64-slice CT, clearly discernible noncalcified atherosclerotic coronary plaques can be detected in a large group of patients with an intermediate risk for having CAD. The assessment of these plaques by CT angiography may allow for improved cardiovascular risk stratification.
authors.affiliation: Klinik für Herz- und Kreislauferkrankungen, Klinik an der TU München, Munich, Germany. hausleiter@dhm.mhn.de
authors.forename: Jörg
authors.initials: J
authors.lastname: Hausleiter
authors.forename: Tanja
authors.initials: T
authors.lastname: Meyer
authors.forename: Martin
authors.initials: M
authors.lastname: Hadamitzky
authors.forename: Adnan
authors.initials: A
authors.lastname: Kastrati
authors.forename: Stefan
authors.initials: S
authors.lastname: Martinoff
authors.forename: Albert
authors.initials: A
authors.lastname: Schömig
mesh_terms: D000328:Adult; D000465:Algorithms; D002097:C-Reactive Protein / Q000032:analysis; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology; D023921:Coronary Stenosis / Q000097:blood / Q000000981:diagnostic imaging* / Q000453:epidemiology; D003331:Coronary Vessels / Q000737:chemistry / Q000473:pathology; D005260:Female; D006801:Humans; D008055:Lipids / Q000032:analysis; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D008055:Lipids; D002097:C-Reactive Protein