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

• DOI: 10.5935/abc.20180063
• Publication Date: 2018-03-28T20:21:33Z
• Authors: Fabíola Santos Ga...; Luiz Flávio Galvã...; Enaldo Vieira de ...; Antônio Carlos So...; Ibraim Masciarell...; Sara Melo Macedo ...; Carlos José Olive...; Maria Júlia Silve...; Flávio Mateus do ...; Joselina Luzia Me...
• Keywords: Fatores de Risco; Male; Computed Tomography Angiography; Coronary Artery Disease; Doenças Cardiovasculares/mortalidade; Body Mass Index; 03 medical and health sciences; 0302 clinical medicine; Doença da Artéria Coronariana/diagnóstico; Risk Factors; Diseases of the circulatory (Cardiovascular) system; Humans; Calcium Signaling; Prospective Studies; Cardiovascular Diseases/mortality; Aged; Middle Aged; Plaque, Atherosclerotic; Cross-Sectional Studies; RC666-701; Sinalização do Cálcio; Placa Aterosclerótica; Coronary, Angiotomography; Original Article; Calcium; Female; Coronary Artery Disease/diagnosis; Angiotomografia das Coronárias; Biomarkers; Brazil

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.