Gabriel FS, Gonçalves LFG, Melo EVD, Sousa ACS, Pinto IMF, Santana SMM, Matos CJOD, Souto MJS, Conceição FMDS, Oliveira JLM. Atherosclerotic Plaque in Patients with Zero Calcium Score at Coronary Computed Tomography Angiography.
Arq Bras Cardiol 2018;
110:420-427. [PMID:
29723329 PMCID:
PMC5967134 DOI:
10.5935/abc.20180063]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 11/22/2017] [Indexed: 11/20/2022] Open
Abstract
Background
In view of the high mortality for cardiovascular diseases, it has become
necessary to stratify the main risk factors and to choose the correct
diagnostic modality. Studies have demonstrated that a zero calcium score
(CS) is characteristic of a low risk for cardiovascular events. However, the
prevalence of individuals with coronary atherosclerotic plaques and zero CS
is conflicting in the specialized literature.
Objective
To evaluate the frequency of patients with coronary atherosclerotic plaques,
their degree of obstruction and associated factors in patients with zero CS
and indication for coronary computed tomography angiography (CCTA).
Methods
This is a cross-sectional, prospective study with 367 volunteers with zero CS
at CCTA in four diagnostic imaging centers in the period from 2011 to 2016.
A significance level of 5% and 95% confidence interval were adopted.
Results
The frequency of atherosclerotic plaque in the coronary arteries in 367
patients with zero CS was 9.3% (34 individuals). In this subgroup, mean age
was 52 ± 10 years, 18 (52.9%) were women and 16 (47%) had significant
coronary obstructions (> 50%), with involvement of two or more segments
in 4 (25%) patients. The frequency of non-obese individuals (90.6% vs 73.9%,
p = 0.037) and alcohol drinkers (55.9% vs 34.8%, p = 0.015) was
significantly higher in patients with atherosclerotic plaques, with an odds
ratio of 3.4 for each of this variable.
Conclusions
The frequency of atherosclerotic plaque with zero CS was relatively high,
indicating that the absence of calcification does not exclude the presence
of plaques, many of which obstructive, especially in non-obese subjects and
alcohol drinkers.
Collapse