Cargando…
The Atherosclerosis Profile by Coronary Computed Tomography Angiography (CTA) in Symptomatic Patients with Coronary Artery Calcium Score Zero
(1) Background: Whether it is safe to exclude coronary artery disease (CAD) in symptomatic patients with coronary artery calcium score (CACS 0), is an open debate. To compare coronary CTA including high-risk plaque (HRP) features in symptomatic patients with CACS 0 (2) Methods: 1709 symptomatic pati...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9498007/ https://www.ncbi.nlm.nih.gov/pubmed/36140444 http://dx.doi.org/10.3390/diagnostics12092042 |
_version_ | 1784794649010896896 |
---|---|
author | Feuchtner, Gudrun Beyer, Christoph Barbieri, Fabian Spitaler, Philipp Dichtl, Wolfgang Friedrich, Guy Widmann, Gerlig Plank, Fabian |
author_facet | Feuchtner, Gudrun Beyer, Christoph Barbieri, Fabian Spitaler, Philipp Dichtl, Wolfgang Friedrich, Guy Widmann, Gerlig Plank, Fabian |
author_sort | Feuchtner, Gudrun |
collection | PubMed |
description | (1) Background: Whether it is safe to exclude coronary artery disease (CAD) in symptomatic patients with coronary artery calcium score (CACS 0), is an open debate. To compare coronary CTA including high-risk plaque (HRP) features in symptomatic patients with CACS 0 (2) Methods: 1709 symptomatic patients (age, mean 57.5 ± 16 years, 39.6% females) referred to coronary CTA for clinical indications were included. CACS, coronary stenosis (CADRADS) severity and HRP features (low-attenuation-plaque, spotty calcification, positive remodeling, NRS) were recorded. (3) Results: Of 1709 patients, 665 with CACS 0 were finally included. 562 (84.5%) had no CAD by CTA while 103 of 665 (15.4%) had CAD. Stenosis was minimal <25% in 79, mild <50% in 20, moderate in 1 and severe >70% in 3 patients. The rate of obstructive CAD was low with 4/665 (0.61%). The majority of patients had non-obstructive CAD (<50% stenosis) (99/103; 96.1%). A high proportion of patients with non-obstructive CAD had at least one HRP (52/103; 50.4%) per patient. (4) Conclusions: The rate of obstructive CAD is very low in symptomatic patients with CACS 0, and non-obstructive CAD domineering. CACS 0 does not rule out non-obstructive CAD and misses patients in which primary preventive measures are indicated. More than half of patients with non-obstructive CAD had high-risk plaque, highlighting the importance of quantitative plaque analysis. |
format | Online Article Text |
id | pubmed-9498007 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-94980072022-09-23 The Atherosclerosis Profile by Coronary Computed Tomography Angiography (CTA) in Symptomatic Patients with Coronary Artery Calcium Score Zero Feuchtner, Gudrun Beyer, Christoph Barbieri, Fabian Spitaler, Philipp Dichtl, Wolfgang Friedrich, Guy Widmann, Gerlig Plank, Fabian Diagnostics (Basel) Article (1) Background: Whether it is safe to exclude coronary artery disease (CAD) in symptomatic patients with coronary artery calcium score (CACS 0), is an open debate. To compare coronary CTA including high-risk plaque (HRP) features in symptomatic patients with CACS 0 (2) Methods: 1709 symptomatic patients (age, mean 57.5 ± 16 years, 39.6% females) referred to coronary CTA for clinical indications were included. CACS, coronary stenosis (CADRADS) severity and HRP features (low-attenuation-plaque, spotty calcification, positive remodeling, NRS) were recorded. (3) Results: Of 1709 patients, 665 with CACS 0 were finally included. 562 (84.5%) had no CAD by CTA while 103 of 665 (15.4%) had CAD. Stenosis was minimal <25% in 79, mild <50% in 20, moderate in 1 and severe >70% in 3 patients. The rate of obstructive CAD was low with 4/665 (0.61%). The majority of patients had non-obstructive CAD (<50% stenosis) (99/103; 96.1%). A high proportion of patients with non-obstructive CAD had at least one HRP (52/103; 50.4%) per patient. (4) Conclusions: The rate of obstructive CAD is very low in symptomatic patients with CACS 0, and non-obstructive CAD domineering. CACS 0 does not rule out non-obstructive CAD and misses patients in which primary preventive measures are indicated. More than half of patients with non-obstructive CAD had high-risk plaque, highlighting the importance of quantitative plaque analysis. MDPI 2022-08-24 /pmc/articles/PMC9498007/ /pubmed/36140444 http://dx.doi.org/10.3390/diagnostics12092042 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Feuchtner, Gudrun Beyer, Christoph Barbieri, Fabian Spitaler, Philipp Dichtl, Wolfgang Friedrich, Guy Widmann, Gerlig Plank, Fabian The Atherosclerosis Profile by Coronary Computed Tomography Angiography (CTA) in Symptomatic Patients with Coronary Artery Calcium Score Zero |
title | The Atherosclerosis Profile by Coronary Computed Tomography Angiography (CTA) in Symptomatic Patients with Coronary Artery Calcium Score Zero |
title_full | The Atherosclerosis Profile by Coronary Computed Tomography Angiography (CTA) in Symptomatic Patients with Coronary Artery Calcium Score Zero |
title_fullStr | The Atherosclerosis Profile by Coronary Computed Tomography Angiography (CTA) in Symptomatic Patients with Coronary Artery Calcium Score Zero |
title_full_unstemmed | The Atherosclerosis Profile by Coronary Computed Tomography Angiography (CTA) in Symptomatic Patients with Coronary Artery Calcium Score Zero |
title_short | The Atherosclerosis Profile by Coronary Computed Tomography Angiography (CTA) in Symptomatic Patients with Coronary Artery Calcium Score Zero |
title_sort | atherosclerosis profile by coronary computed tomography angiography (cta) in symptomatic patients with coronary artery calcium score zero |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9498007/ https://www.ncbi.nlm.nih.gov/pubmed/36140444 http://dx.doi.org/10.3390/diagnostics12092042 |
work_keys_str_mv | AT feuchtnergudrun theatherosclerosisprofilebycoronarycomputedtomographyangiographyctainsymptomaticpatientswithcoronaryarterycalciumscorezero AT beyerchristoph theatherosclerosisprofilebycoronarycomputedtomographyangiographyctainsymptomaticpatientswithcoronaryarterycalciumscorezero AT barbierifabian theatherosclerosisprofilebycoronarycomputedtomographyangiographyctainsymptomaticpatientswithcoronaryarterycalciumscorezero AT spitalerphilipp theatherosclerosisprofilebycoronarycomputedtomographyangiographyctainsymptomaticpatientswithcoronaryarterycalciumscorezero AT dichtlwolfgang theatherosclerosisprofilebycoronarycomputedtomographyangiographyctainsymptomaticpatientswithcoronaryarterycalciumscorezero AT friedrichguy theatherosclerosisprofilebycoronarycomputedtomographyangiographyctainsymptomaticpatientswithcoronaryarterycalciumscorezero AT widmanngerlig theatherosclerosisprofilebycoronarycomputedtomographyangiographyctainsymptomaticpatientswithcoronaryarterycalciumscorezero AT plankfabian theatherosclerosisprofilebycoronarycomputedtomographyangiographyctainsymptomaticpatientswithcoronaryarterycalciumscorezero AT feuchtnergudrun atherosclerosisprofilebycoronarycomputedtomographyangiographyctainsymptomaticpatientswithcoronaryarterycalciumscorezero AT beyerchristoph atherosclerosisprofilebycoronarycomputedtomographyangiographyctainsymptomaticpatientswithcoronaryarterycalciumscorezero AT barbierifabian atherosclerosisprofilebycoronarycomputedtomographyangiographyctainsymptomaticpatientswithcoronaryarterycalciumscorezero AT spitalerphilipp atherosclerosisprofilebycoronarycomputedtomographyangiographyctainsymptomaticpatientswithcoronaryarterycalciumscorezero AT dichtlwolfgang atherosclerosisprofilebycoronarycomputedtomographyangiographyctainsymptomaticpatientswithcoronaryarterycalciumscorezero AT friedrichguy atherosclerosisprofilebycoronarycomputedtomographyangiographyctainsymptomaticpatientswithcoronaryarterycalciumscorezero AT widmanngerlig atherosclerosisprofilebycoronarycomputedtomographyangiographyctainsymptomaticpatientswithcoronaryarterycalciumscorezero AT plankfabian atherosclerosisprofilebycoronarycomputedtomographyangiographyctainsymptomaticpatientswithcoronaryarterycalciumscorezero |