Atherosclerosis still present in patients with calcium score of zero

Most plaques observed in patients with calcium score of zero were nonobstructive.

Issue: December 2008

Patients who have a calcium score of zero may still have significant amounts of atherosclerotic plaque.

Researchers for the study retrospectively reviewed a series of 2,176 patients who had undergone contrast-enhanced coronary CTA and analyzed the presence of calcified plaque in the 17 coronary segments. The results of the study were presented at the Radiological Society of North America 94th Scientific Assembly and Annual Meeting in Chicago.

“The calcium score of zero is another type of variant of low near-term risk for coronary events,” James P. Earls, MD, vice president and medical director of Fairfax Radiological Consultants in Fairfax, Va., said in a presentation. “However, it does not mean that they do not have coronary atherosclerosis, so we decided to determine the prevalence of coronary atherosclerosis in a population whose calcium scores were zero.”

According to the researchers, the original reports indicated that about 14% of those with a calcium score of zero showed noncalcified plaque in the angiograms. After a rereading by two blinded reviewers, the percentage of patients with a calcium score of zero rose to 26%. Sixty-eight percent of the patient had plaque <25% luminal narrowing, 31% had <50% narrowing and four patients had stenosis >50%.

“Patients with a calcium score of zero still had a substantial amount of atherosclerosis,” Earls said. “Twenty-six percent of the patients had multiple atherosclerosis despite the negative calcium result, and a substantial number of these were not reported in the initial reports.” – by Eric Raible

For more information:

Earls J. #SSK02-03. Presented at: Radiological Society of North America 94th Scientific Assembly and Annual Meeting; Nov. 30-Dec 5, 2008; Chicago.