Atherosclerotic Plaque in Patients with Zero Calcium Score at Coronary Computed Tomography Angiography

• Published in: Arquivos brasileiros de cardiologia Vol. 110; no. 5; pp. 420 - 427
• Main Authors: Gabriel, Fabíola Santos, Gonçalves, Luiz Flávio Galvão, Melo, Enaldo Vieira de, Sousa, Antônio Carlos Sobral, Pinto, Ibraim Masciarelli Francisco, Santana, Sara Melo Macedo, Matos, Carlos José Oliveira de, Souto, Maria Júlia Silveira, Conceição, Flávio Mateus do Sacramento, Oliveira, Joselina Luzia Menezes
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira de Cardiologia - SBC 01-05-2018; Sociedade Brasileira de Cardiologia (SBC)
• Subjects: Aged; Biomarkers - analysis; Body Mass Index; Brazil - epidemiology; Calcium - analysis; Calcium Signaling; CARDIAC & CARDIOVASCULAR SYSTEMS; Cardiovascular Diseases/mortality; Computed Tomography Angiography; Coronary Artery Disease - complications; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - epidemiology; Coronary Artery Disease/diagnosis; Coronary, Angiotomography; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Original; Plaque, Atherosclerotic; Plaque, Atherosclerotic - complications; Plaque, Atherosclerotic - diagnostic imaging; Plaque, Atherosclerotic - epidemiology; Prospective Studies; Risk Factors; Coronary Artery Disease/diagnosis; Angiotomografia das Coronárias; Cardiovascular Diseases/mortality; Sinalização do Cálcio; Risk Factors; Placa Aterosclerótica; Plaque, Atherosclerotic; Calcium Signaling; Coronary, Angiotomography; Doenças Cardiovasculares/mortalidade; Doença da Artéria Coronariana/diagnóstico; Fatores de Risco
• ISSN: 0066-782X; 1678-4170; 1678-4170
• DOI: 10.5935/abc.20180063

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.
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).
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.
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.
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.