What is the clinical evidence from this study?

Study design: Observational. Population: Coronary artery disease in low-risk patients (n=434). Intervention: Lipid profile assessment (Lp(a), ApoB/ApoA1 ratio) vs. Patients with CAC score ≥1. Primary outcome: Association of ApoB/ApoA1 ratio with non-calcified plaques >25% stenosis in CAC-zero patients (OR 2.173, 95% CI 0.164-28.774, p=0.556).

What does this research mean for the field?

In patients with a zero CAC score, Lp(a) levels >126 mg/dl are associated with the presence of non-calcified plaques exceeding 25% stenosis. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.CHALLENGES_CONSENSUS.

What question did this study set out to answer?

This research aims to identify lipid plaque predictors to enhance cardiovascular risk stratification in low-risk patients with a zero CAC score.

February 6, 2026European Heart Journal

Identification of different lipid profiles in patients with zero calcium score with or without plaques after coronary computed tomography: a prospective registry to refine primary prevention

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Key result

High Lp(a) linked to non-calcified plaques in CAC-zero patients, whereas ApoB/ApoA1 shows no association.

OR 2.173
95% CI 0.164-28.774
P=0.556
n=434

Why the study?

A zero CAC score indicates low cardiovascular risk but does not exclude CAD, and traditional lipid markers may not capture risk in these patients.

Do advanced lipid markers like Lp(a) predict the presence of non-calcified plaques in patients with a zero CAC score?

Population

434 low-risk patients undergoing coronary CCTA

Comparison

Lipid profiles in patients with CAC score = 0 vs CAC score ≥1

Design

Single-center prospective registry study

Authors

SASara Alsubai HEHesham Elzomor FAFoziyah Alqahtani

Discussion

Member takes

Overview

High Lp(a) may flag occult plaque in CAC-zero patients; leaves open whether testing refines stratification or outcomes.

Key Points

This research aims to identify lipid plaque predictors to enhance cardiovascular risk stratification in low-risk patients with a zero CAC score.
Ongoing single-center study at University Hospital Galway.
Assessment of CAC scores via non-contrast coronary computed tomography (CCTA).
Blood samples collected for lipid analysis prior to scanning.
32 participants with CAD were identified despite a zero CAC score.
Significant association of Lp(a) levels with plaques >25% in CAC-zero cohort (p=0.009).
ApoB/ApoA1 ratio was significantly linked to plaques only in patients with CAC ≥1 (OR 8.272, p=0.036).
A threshold Lp(a) level of >126 mg/dl identified as optimal for detecting non-calcified plaques in CAC-zero patients.

Study Design

Type

Observational (n=434)

Multicenter

Structured PICO

Do advanced lipid markers like Lp(a) predict the presence of non-calcified plaques in patients with a zero CAC score?

Population

434 low-risk patients undergoing coronary CCTA, mean age 56.5±10 years, 46.3% female.

Intervention

Lipid profile assessment including Lipoprotein(a) and ApoB/ApoA-1 ratio

Comparator

Patients with CAC score ≥1 vs. CAC score = 0

Outcome

Presence of non-calcified coronary plaques >25% stenosissurrogate

Main Result

Effect estimate: OR 2.173 (95% CI 0.164-28.774)

p-value: p=0.556

Elevated Lp(a) levels (>126 mg/dl) are associated with the presence of non-calcified plaques >25% stenosis in patients with a zero CAC score, suggesting a role for advanced lipid testing to refine primary prevention in this population.

Cite This Study

Alsubai et al. (2025) conducted an observational in Coronary artery disease in low-risk patients (n=434). Lipid profile assessment (Lp(a), ApoB/ApoA1 ratio) vs. Patients with CAC score ≥1 was evaluated on Association of ApoB/ApoA1 ratio with non-calcified plaques >25% stenosis in CAC-zero patients (OR 2.173, 95% CI 0.164-28.774, p=0.556). In patients with a zero calcium score, Lp(a) levels >126 mg/dl were significantly associated with non-calcified plaques >25% stenosis (p=0.009), whereas the ApoB/ApoA1 ratio was not (OR 2.173).

synapsesocial.com/papers/698586388f7c464f2300a365 https://doi.org/10.1093/eurheartj/ehaf784.3474

View Full Paper

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February 6, 2026European Heart Journal

Identification of different lipid profiles in patients with zero calcium score with or without plaques after coronary computed tomography: a prospective registry to refine primary prevention

View Full Paper

Ask AI

Bookmark

Key result

High Lp(a) linked to non-calcified plaques in CAC-zero patients, whereas ApoB/ApoA1 shows no association.

OR 2.173
95% CI 0.164-28.774
P=0.556
n=434

Why the study?

A zero CAC score indicates low cardiovascular risk but does not exclude CAD, and traditional lipid markers may not capture risk in these patients.

Do advanced lipid markers like Lp(a) predict the presence of non-calcified plaques in patients with a zero CAC score?

Population

434 low-risk patients undergoing coronary CCTA

Comparison

Lipid profiles in patients with CAC score = 0 vs CAC score ≥1

Design

Single-center prospective registry study

Authors

SASara Alsubai HEHesham Elzomor FAFoziyah Alqahtani

Discussion

Member takes

Overview

High Lp(a) may flag occult plaque in CAC-zero patients; leaves open whether testing refines stratification or outcomes.

Key Points

This research aims to identify lipid plaque predictors to enhance cardiovascular risk stratification in low-risk patients with a zero CAC score.
Ongoing single-center study at University Hospital Galway.
Assessment of CAC scores via non-contrast coronary computed tomography (CCTA).
Blood samples collected for lipid analysis prior to scanning.
32 participants with CAD were identified despite a zero CAC score.
Significant association of Lp(a) levels with plaques >25% in CAC-zero cohort (p=0.009).
ApoB/ApoA1 ratio was significantly linked to plaques only in patients with CAC ≥1 (OR 8.272, p=0.036).
A threshold Lp(a) level of >126 mg/dl identified as optimal for detecting non-calcified plaques in CAC-zero patients.

Study Design

Type

Observational (n=434)

Multicenter

Structured PICO

Do advanced lipid markers like Lp(a) predict the presence of non-calcified plaques in patients with a zero CAC score?

Population

434 low-risk patients undergoing coronary CCTA, mean age 56.5±10 years, 46.3% female.

Intervention

Lipid profile assessment including Lipoprotein(a) and ApoB/ApoA-1 ratio

Comparator

Patients with CAC score ≥1 vs. CAC score = 0

Outcome

Presence of non-calcified coronary plaques >25% stenosissurrogate

Main Result

Effect estimate: OR 2.173 (95% CI 0.164-28.774)

p-value: p=0.556

Cite This Study

synapsesocial.com/papers/698586388f7c464f2300a365 https://doi.org/10.1093/eurheartj/ehaf784.3474

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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