title: Noncalcified plaque: relationship between results of multislice computed tomography, risk factors, and late clinical outcome.
abstract: BACKGROUND
  Contrast-enhanced multislice computed tomographic angiography (MSCTA) detects noncalcified plaque (NCP) in coronary arteries and associated coronary stenoses. However, the clinical relevance of NCP is poorly defined.
  
  
  OBJECTIVE
  Our goal was to examine the relationship NCP, risk factors (RFs), and clinical follow-up in unselected outpatients undergoing MSCTA.
  
  
  METHODS
  Five hundred six patients undergoing contrast MSCTA were evaluated for NCP (intraluminal density 25 < Hounsfield units < 130). One hundred twenty-four patients (24.5%) had calcium scores (CAC) of zero. Of these, 111 patients were examined for RFs and followed clinically for a mean of 34 months.
  
  
  RESULTS
  Of 124 patients with zero CAC, 111 (89.5%) included 52 (46.8%) with no NCP, 40 (36.0%) with NCP, and mild luminal stenosis, 14 (12.6%) and 5 (4.5%) with NCP causing significant and severe stenosis, respectively. Patients in each group were similar in age but differed significantly in number of RFs. Current or former smokers, hypertensive, and obese patients had more NCP and associated stenosis. At a mean of 34 months, there were no events in the no NCP group, 2/54 (3.7%) events in the NCP without severe stenosis group (one sudden cardiac death and one ventricular tachycardia), and 2/5 (40.0%) patients had revascularization in the NCP with severe stenosis group.
  
  
  CONCLUSIONS
  (1) In patients with zero CAC, presence of NCP on MSCTA was associated with more RFs, especially smoking, obesity, and hypertension. (2) NCP can result in severe coronary stenosis. (3) NCP detected by MSCTA in patients with zero CAC may identify patients with late cardiac events.
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Niti R
authors.initials: NR
authors.lastname: Aggarwal
authors.forename: Thomas
authors.initials: T
authors.lastname: Knickelbine
authors.forename: Aaron
authors.initials: A
authors.lastname: Tande
authors.forename: Luke
authors.initials: L
authors.lastname: Stoltzfus
authors.forename: John R
authors.initials: JR
authors.lastname: Lesser
authors.forename: Robert S
authors.initials: RS
authors.lastname: Schwartz
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000401:mortality / Q000628:therapy; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D009765:Obesity / Q000150:complications; D016017:Odds Ratio; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging* / Q000209:etiology / Q000401:mortality / Q000628:therapy; D011237:Predictive Value of Tests; D011379:Prognosis; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects; D013997:Time Factors; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media