Key result
Coronary CTA identifies atherosclerotic plaques in ~22% of asymptomatic middle-aged adults.
Why the study?
There is a paucity of information regarding the role of coronary CTA for detecting occult CAD, characterizing plaque composition, and informing risk stratification in asymptomatic middle-aged individuals.
Cohort (n=1,000)
Although coronary CTA detects occult CAD in 22% of asymptomatic middle-aged adults (5% with >=50% stenosis), routine screening is not recommended due to favorable midterm prognosis and radiation exposure concerns.
Answers are grounded in this paper and cite their sources.
Atherosclerotic plaques detected in 22% of asymptomatic middle-aged adults by CTA; leaves open its value for risk stratification.
Objectives The purpose of this study was to evaluate the prevalence of occult coronary artery disease (CAD) with coronary computed tomography angiography (CTA) to characterize plaque composition and to evaluate the potential of this new technology to impact risk stratification in asymptomatic middle-aged subjects. Background There is a paucity of information regarding the role of CTA for the detection of occult CAD in asymptomatic individuals. Methods We consecutively enrolled 1,000 middle-aged asymptomatic subjects (age 50 +/- 9 years, 63% men) who underwent CTA (64-slice multidetector row computed tomography) as part of a general health evaluation. Results Atherosclerotic plaques were identified in 215 (22%, 2 +/- 1 segments/subject) individuals; 40 individuals (4%) had only noncalcified plaques. Fifty-two (5%) subjects had significant (>or=50%) diameter stenosis and 21 (2%) had severe (>or=75%) stenosis. Thirteen (25%) and 30 (58%) subjects with significant stenosis were classified into National Cholesterol Education Program low-risk and mild coronary calcification (coronary artery calcium scores <100), respectively. Midterm follow-up (17 +/- 2 months) revealed 15 cardiac events only in those with CAD on CTA: 1 unstable angina requiring hospital stay and 14 revascularization procedures. Most (87%) events occurred within 90 days of index CTA. Conclusions The prevalence of occult CAD in apparently healthy individuals was not negligible, although their midterm prognosis was good. CTA has a potential to provide a better insight about the occult CAD in this population. However, on the basis of our results and considering present radiation exposure data, we cannot recommend that CTA be used as a screening tool for this population at this point.
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Choi et al. (2008) conducted a cohort in Occult coronary artery disease in asymptomatic individuals (n=1,000). Coronary computed tomography angiography (64-slice multidetector row computed tomography) was evaluated on Prevalence of atherosclerotic plaques on coronary computed tomography angiography. Coronary CTA identified atherosclerotic plaques in 22% (215/1,000) and significant stenosis in 5% of asymptomatic middle-aged adults, with 15 cardiac events over 17 months.
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