CCTA links noncalcified arterial plaque to diabetes, blood pressure and cholesterol

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 - CCTA segmentation
From left to right: Coronary segmentation model of coronary tree; curved multiplanar reconstruction of the left anterior descending artery; representative cross-sectional images, with green shading marking noncalcified plaque.
Source: RSNA/Radiology (DOI:

CT angiography (CCTA) is effective at measuring levels of unstable arterial plaque in asymptomatic patients, which is associated with the development of diabetes, high blood pressure and elevated “bad” cholesterol, according to results of a study published online June 2 in the journal Radiology.

Coronary artery disease (CAD) kills 17 million men and women globally each year, making it the leading cause of death worldwide, according to lead author Karen Rodriguez, and her colleagues at the National Institutes of Health Clinical Center.

“Coronary artery calcium score at CT has been validated as an independent prognostic indicator of CAD,” wrote Rodriguez et al. “However, detection of ‘soft,’ or noncalcified, plaque at coronary CT angiography may further enhance risk stratification and prognosis over the use of the CAC score alone.”

With this in mind, Rodriguez and her team set out to determine the relationship between coronary plaque burdens and cardiovascular risk factors. To do so they performed a prospective study on 202 asymptomatic patients above the age of 55 with low-to-moderate risk of heart disease using CCTA to determine total, calcified and noncalcified arterial plaque levels, and then compared their findings with the patients’ already existing cardiovascular health and risk factors.

Their results showed that the patients’ noncalcified plaque index was positively correlated with systolic blood pressure, diabetes and low-density lipoprotein (LDL) cholesterol level. They also found that total coronary plaque was more prominent in men than in women.

The researchers believe their findings support an increased emphasis on the use of CCTA to determine cardiovascular risk through plaque assessment. “CCTA shows promise as a tool for quantifying total and noncalcified coronary artery plaque,” the authors concluded. “Our results involving noninvasive intravascular US–like analysis of coronary plaque point to the importance of LDL cholesterol level as a significant biologic predictor of noncalcified plaque.”