The presence, characterization and prognosis of coronary plaques among patients with zero coronary calcium scores

Seth Uretsky, Alan Rozanski, Padmakshi Singh, Azhar Supariwala, Prashanth Atluri, Sripal Bangalore, Thomas W. Pappas, Edward A. Fisher, M. Robert Peters

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Patients with coronary artery calcium (CAC) scores of zero are generally considered not to have atherosclerosis. Recent studies involving computed tomography coronary angiography (CTCA) challenge this assumption. This goal of the present study is to assess the frequency, morphology, location, and the prognosis of patients with plaque detected on CTCA and zero CAC. 1,119 patients (51 ± 12 years, 52% male) with a zero CAC score during CTCA study were retrospectively identified. The CTCA studies were assessed for the presence, morphology, location and severity of all coronary plaques. All-cause mortality was assessed. The prevalence of coronary plaque was 13% (147 patients). Among the 212 plaques identified 154 (73%) were non-calcified, 28 (13%) were calcified, and 30 (14%) were of mixed morphology. Notably, C70% stenosis was noted among only 0.4% of all patients. ROC analysis revealed that coronary artery disease risk factors did not add to the prediction of plaque among our patients. Over a mean follow-up of 2.5 ± 0.6 years there were 4 deaths (0.4%), all in patients without coronary plaque on CTCA. The presence of coronary plaque is not uncommon among patients with zero CAC scores. These plaques were rarely associated with hemodynamically significant stenoses and were associated with an excellent prognosis. Clinical factors do not appear to be useful in predicting which patients with zero CAC scores have undetected coronary plaque.

Original languageEnglish (US)
Pages (from-to)805-812
Number of pages8
JournalInternational Journal of Cardiovascular Imaging
Volume27
Issue number6
DOIs
StatePublished - Jul 1 2011
Externally publishedYes

Fingerprint

Calcium
Coronary Angiography
Coronary Vessels
Pathologic Constriction
ROC Curve
Coronary Artery Disease
Atherosclerosis
Computed Tomography Angiography
Mortality

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Uretsky, Seth ; Rozanski, Alan ; Singh, Padmakshi ; Supariwala, Azhar ; Atluri, Prashanth ; Bangalore, Sripal ; Pappas, Thomas W. ; Fisher, Edward A. ; Peters, M. Robert. / The presence, characterization and prognosis of coronary plaques among patients with zero coronary calcium scores. In: International Journal of Cardiovascular Imaging. 2011 ; Vol. 27, No. 6. pp. 805-812.
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Uretsky, S, Rozanski, A, Singh, P, Supariwala, A, Atluri, P, Bangalore, S, Pappas, TW, Fisher, EA & Peters, MR 2011, 'The presence, characterization and prognosis of coronary plaques among patients with zero coronary calcium scores', International Journal of Cardiovascular Imaging, vol. 27, no. 6, pp. 805-812. https://doi.org/10.1007/s10554-010-9730-0

The presence, characterization and prognosis of coronary plaques among patients with zero coronary calcium scores. / Uretsky, Seth; Rozanski, Alan; Singh, Padmakshi; Supariwala, Azhar; Atluri, Prashanth; Bangalore, Sripal; Pappas, Thomas W.; Fisher, Edward A.; Peters, M. Robert.

In: International Journal of Cardiovascular Imaging, Vol. 27, No. 6, 01.07.2011, p. 805-812.

Research output: Contribution to journalArticle

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