Aims: To prospectively investigate the prevalence of coronary artery plaques (CAP) as detected by CT-based angiography in a large number of consecutive individuals with no history of coronary artery disease (CAD) or acute coronary syndrome; to evaluate whether traditional risk factors are related to prevalence of CAP and to the expected 10-year risk of first major or fatal cardiovascular event (CVE).
Design: Prospective, single center, cross-sectional study
Setting: The division of Cardiology at Fondazione Cardiocentro Ticino Lugano Switzerland
Methods: We prospectively included 920 consecutive individuals with no history of CAD who underwent computed tomography coronary angiography (CTCA). Risk estimation of fatal and non-fatal CVE was assessed using Global Assessment Risk (GAR) and Systematic Coronary Risk Evaluation (SCORE), respectively. Logistic regression was used to assess the association of risk factors (RFs) with the prevalence of CAP.
Results: CAP were found in 459 (49.9%) individuals. Older age, higher BMI, male gender, diabetes, hypertension and dyslipidemia all increased the likelihood of CAP burden at univariable analysis (p<0.001). At the multivariable analysis older age, male gender, hypertension, and diabetes independently increased the likelihood of CAP burden (p<0.001). An increase in likelihood of CAP was observed in presence of 1,2 and 3 or more RFs and with an increasing value of GAR and SCORE. Notably, about 18% of subjects with CAP did not report any traditional RFs and among individuals without CAPs, 12% had 3 or more RFs.
Conclusions: A direct relationship between the prevalence of CAP, number of RFs and the related 10-year risk of CVE was found. Eighteen per cent of subjects without RFs had CAP. In these individuals CTCA may help in further optimizing the risk reduction strategies on an individual basis.
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