Prevalence of Noncalcified Coronary Plaque in Patients With Calcium Score of 0: The Silent Enemy

Angiology, 04/27/2012

Koulaouzidis G et al. - Computer tomography coronary angiography could be of diagnostic value in symptomatic patients with multiple risk factors for coronary artery disease (CAD), even in the absence of CAC.


  • The authors evaluated the prevalence and degree of stenosis caused by NCAP in patients without coronary artery calcification (CAC).
  • A retrospective analysis of 447 symptomatic patients with 0 CAC score revealed negative CTCA in 400 (89.5%). Noncalcified coronary artery plaques were demonstrated in 47 (10.5%), with 4 presenting stenosis >50%.


  • Patients with positive CTCA, compared to those with normal CTCA, had significantly higher mean age (56.2 years vs 50.6 years, P < .004) and higher pretest coronary artery disease (CAD) probability (26% vs 34%, P < .0001).
  • Noncalcified coronary artery plaque was predominantly developed in the proximal segment of the left anterior descending artery.
  • Noncalcified coronary artery plaque is present in up to 10% of patients with a CAC score of 0.

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