Silent Atherosclerosis

A new study in Circulation used coronary CTA scans and CAC scoring to reveal a surprisingly high prevalence of “silent” coronary artery atherosclerosis in the general population, suggesting that this could “lay the foundation” for future CT-based cardiac screening programs.

The Study – The researchers analyzed CCTA and CAC exams from 25k randomly recruited Swedish participants (50-64yrs, none w/ known coronary heart disease) finding that:

  • 42% had CCTA-detected atherosclerosis
  • 8.3% had noncalcified plaques
  • 5.2% had significant stenosis
  • 1.9% had serious coronary artery diseases
  • All participants with >400 CAC scores had atherosclerosis (yes, 100%), and 45.7% had significant stenosis
  • Some participants with 0 CAC scores had atherosclerosis (5.5%) and significant stenosis (0.4%)
  • So, CAC-based screening might still miss some at-risk patients

The Takeaway – 2021 brought a notable surge in academic and business efforts focused on CT-based cardiac screening, and this study’s revelation about “silent” atherosclerosis in the general population suggests that cardiac screening’s momentum will continue.

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-- The Imaging Wire team