title: Prevalence of subclinical atherosclerosis in asymptomatic patients with low-to-intermediate risk by 64-slice computed tomography.
abstract: BACKGROUND
  Recent research has shown that cardiovascular risk scoring significantly underestimates or misclassifies risk in key subsets of the population. There is a growing need for a noninvasive imaging to detect a subclinical atherosclerosis. Thus we hypothesized that 64-slice computed tomography (CT) could effectively detect subclinical atherosclerosis in asymptomatic patients with low-to-intermediate risk.
  
  
  METHODS
  Four hundred and fifteen asymptomatic patients with coronary risk factors underwent 64-slice CT. When 64-slice CT showed a significant stenosis we recommended that patients receive stress myocardial perfusion imaging (MPI). When MPI showed ischemic findings, we recommended that patients receive a coronary revascularization procedure. We followed our patients for a mean of 2.8 years (2.4-3.3 years).
  
  
  RESULTS
  We detected coronary plaques in 295 patients (71.1%). Of 135 patients with a negative scan for coronary calcification, noncalcified plaques were detected in 15 patients (11.1%). Two hundred and thirty-five patients (79.7%) had multiple plaques and, on average, one patient had 4.6 plaques. Significant coronary stenosis was detected in 91 patients (21.9%) and 85 patients underwent stress MPI. Myocardial ischemia was found in 27 patients (31.8%) and 21 patients underwent percutaneous coronary intervention. For a mean follow-up period of 2.8 years, four patients developed acute coronary syndrome.
  
  
  CONCLUSIONS
  Our results showed that the prevalence of subclinical atherosclerosis in asymptomatic patients with low-to-intermediate risk was very high and one-fifth of them had significant stenosis as shown by 64-slice CT. However, myocardial ischemia was detected in only one-third of them.
authors.affiliation: Department of Cardiology, Okayama Central Hospital, Okayama, Japan. kiwasaki@kyokuto.or.jp
authors.forename: Kohichiro
authors.initials: K
authors.lastname: Iwasaki
authors.forename: Takeshi
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Aono
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Furukawa
authors.forename: Masanobu
authors.initials: M
authors.lastname: Samukawa
mesh_terms: D000368:Aged; D017130:Angioplasty; D058070:Asymptomatic Diseases / Q000453:epidemiology*; D002114:Calcinosis / Q000175:diagnosis; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D023921:Coronary Stenosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D058226:Plaque, Atherosclerotic / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D015995:Prevalence; D018570:Risk Assessment; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed