Prognostic significance of subtle coronary calcification in patients with zero coronary artery calcium score: From the CONFIRM registry
Atherosclerosis Aug 04, 2020
Han D, Klein E, Friedman J, et al. - Given that small or less dense coronary calcification that can be identified on coronary CT angiography (CCTA) may not be detected with the Agatston coronary artery calcium score (CACS) method, so, researchers focused on the prevalence as well as prognostic value of subtle calcified plaques on CCTA in people with CACS 0. They assessed patients without known CAD who had CAC scan and CCTA, using the prospective multicenter CONFIRM registry. They grouped CACS as 0, 1–10, 11–100, 101–400, and > 400. Based on the visual presence of coronary plaques on CCTA, stratification of patients with CACS 0 was done. A major adverse cardiac event (MACE), defined as death and myocardial infarction, was the primary outcome. Findings revealed the presence of identifiable coronary calcification in a small but non-negligible proportion of patients with CACS 0, and this calcification was identified to be related to an increased risk of MACE. An improvement in the identification of subtle coronary calcification could be brought about by altering CAC image acquisition and/or scoring methods.
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