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Zero CAC Score Does Not Rule Out Atherosclerosis

9.2 percent of those with zero CAC and intermediate 10-year atherosclerotic CVD risk had CCTA-verified atherosclerosis

MONDAY, Sept. 20, 2021 (HealthDay News) — Coronary computed tomography angiography (CCTA) can detect atherosclerosis, even among individuals with no coronary artery calcification (CAC), according to a study published online Sept. 20 in Circulation.

Göran Bergström, M.D., Ph.D., from the University of Gothenburg in Sweden, and colleagues recruited 30,154 randomly invited individuals aged 50 to 64 years to the Swedish Cardiopulmonary Bioimage Study, including those without known coronary heart disease and with high-quality results from CCTA and CAC imaging.

Overall, 25,182 individuals without known coronary heart disease were included. The researchers identified any CCTA-detected atherosclerosis in 42.1 percent of participants; any significant stenosis in 5.2 percent; left main, proximal left anterior descending artery, or three-vessel disease in 1.9 percent; and any noncalcified plaques in 8.3 percent. On average, atherosclerosis onset was delayed by 10 years in women. In older individuals, atherosclerosis was more prevalent and mainly found in the proximal left anterior descending artery. There was an increase noted in the prevalence of CCTA-detected atherosclerosis with increasing CAC scores. All those with a CAC score >400 had atherosclerosis, and 45.7 percent had significant stenosis. Of those with zero CAC, 5.5 and 0.4 percent had atherosclerosis and significant stenosis, respectively. Among participants with zero CAC and intermediate 10-year atherosclerotic cardiovascular disease risk, 9.2 percent had CCTA-verified atherosclerosis.

“A high CAC score means there is a high likelihood of having obstruction of the coronary arteries,” Bergström said in a statement. “However, more importantly, a zero CAC score does not exclude adults from having atherosclerosis, especially if they have many traditional risk factors of coronary disease.”

Several authors disclosed financial ties to the pharmaceutical industry.

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