title: Prevalence of noncalcified coronary plaque in patients with calcium score of 0: the silent enemy.
abstract: Noncalcified coronary artery plaques (NCAPs) are susceptible to rupture, resulting in coronary artery thrombosis. Using computer tomography coronary angiography (CTCA), we evaluated the prevalence and degree of stenosis caused by NCAP in patients without coronary artery calcification (CAC). A retrospective analysis of 447 symptomatic patients with 0 CAC score revealed negative CTCA in 400 (89.5%). Noncalcified coronary artery plaques were demonstrated in 47 (10.5%), with 4 presenting stenosis >50%. Patients with positive CTCA, compared to those with normal CTCA, had significantly higher mean age (56.2 years vs 50.6 years, P < .004) and higher pretest coronary artery disease (CAD) probability (26% vs 34%, P < .0001). Noncalcified coronary artery plaque was predominantly developed in the proximal segment of the left anterior descending artery. Noncalcified coronary artery plaque is present in up to 10% of patients with a CAC score of 0. Computer tomography coronary angiography could be of diagnostic value in symptomatic patients with multiple risk factors for CAD, even in the absence of CAC.
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, Sweden. geokoul@hotmail.com
authors.forename: George
authors.initials: G
authors.lastname: Koulaouzidis
authors.forename: Dafni
authors.initials: D
authors.lastname: Charisopoulou
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Jenkins
authors.forename: Anastasios
authors.initials: A
authors.lastname: Koulaouzidis
authors.forename: Tony
authors.initials: T
authors.lastname: McArthur
mesh_terms: D000328:Adult; D000368:Aged; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000453:epidemiology* / Q000473:pathology; D003331:Coronary Vessels / Q000737:chemistry; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed