People without heart disease or atherosclerosis

A general screening test for atherosclerosis captures calcium-containing plaques in the arteries, but may miss uncalcified deposits, according to a study published today in the journal Circulation.

“It’s important to measure the amount of calcification, but it still doesn’t provide information about non-calcified atherosclerosis, which also increases the risk of heart attack,” he said. Dr. Yoran BelistromePrincipal Investigator and Professor and Senior Consultant in Clinical Physiology, Department of Molecular and Clinical Medicine, Gothenburg University School of Medicine, Sweden.

“It is important to know that silent coronary atherosclerosis is common in middle-aged adults and increases rapidly with gender, age, and risk factors,” he said.

Cardiac CT scans are commonly used as part of an assessment of cardiac risk.

A cross-section scan of a blood vessel gives a score called the coronary artery calcification (CAC) score. This score ranges from 0 to 400. The higher the number, the higher the risk of having a heart attack over the next 10 years.

Nonetheless, a study by Bergström and colleagues found that even some people with low CAC scores could suffer from severe atherosclerosis.

“People who are experiencing chest pain may look safe with a CAC score of zero, but they may still be at risk.” Dr. Lenny Brock PalmerA cardiologist and director of non-invasive cardiac imaging at the Deborah Heart and Lang Center in New Jersey, he told Healthline.

The researchers analyzed data from more than 25,000 people with no history of heart disease who underwent both cardiac CT scans and coronary CT angiography (CCTA) scans.

CCTA provides more advanced radiographic images than the cardiac CT scans used to generate CAC scores.

CCTA scans found that the higher the CAC score, the higher the level of atherosclerosis detected in general.

For example, in study participants with a CAC score close to 400, nearly half showed severe occlusion and more than 50% of blood flow was obstructed in one of the coronary arteries.

However, CCTA scans have shown that people with a CAC score of zero can also develop atherosclerosis.

The study showed that 5% of people with a CAC score of zero detected atherosclerosis with CCTA and 0.4% had significant obstruction of blood flow.

“A high CAC score means that the coronary arteries are likely to be occluded,” says Bergström. “But more importantly, a zero CAC score, especially with many traditional risk factors for coronary artery disease, does not preclude adults from having atherosclerosis.”

Bergström referred to the current American College of Cardiology and the American College of Cardiology Guidelines When it comes to heart attack prevention, adults with a zero CAC score and moderate risk factor levels are said to have a lower risk of future heart attacks.

However, he said, “9.2% of those who fit the explanation were found to have atherosclerosis in the coronary arteries visible by CCTA.”

Bergström said that non-calcified atherosclerosis detected by CCTA is thought to be more likely to cause a heart attack than calcified atherosclerosis.

Overall, the study found one or more non-calcified plaques in 8% of adults who participated in the study.

Bergström said a follow-up study will look at whether people with non-calculated atherosclerosis are at increased risk of future heart attacks.

CCTA with high-dose radiographic images and contrast injection is currently not a recommended part of the heart attack prevention protocol.

However, Lloyd Jones said the findings support the widespread use of CAC scoring for people who do not have a known risk factor for heart disease.

“CAC provides us with most of the information we need,” he said.