Interplay Between Zero CAC, Quantitative Plaque Analysis, and Adverse Events in a Diverse Patient Cohort
Authors' conclusion
In summary, no sex, race, or ethnicity differences were demonstrated in the negative predictive value of a zero CAC; however, patients with ≥2 risk factors had a higher prevalence of plaque.
Study context
- Population
- Patients with stable angina without prior MI or revascularization undergoing coronary CT angiography, Montefiore Healthcare System; diverse cohort (58% Hispanic)66% female
- Participants
- 2,249 patients
- Exposure
- CAC=0 vs CAC>0
- CAC=0n = 1,237
- Outcome
- NPV of CAC=0 for any plaque, obstructive coronary stenosis, and composite of all-cause death, MI or coronary revascularization
- Follow-up
- Median 5.5 years
Methodological detailsregistry-based, single health system
- Registry-based
- Single health system
Main finding
As reported in the abstract
NPV of CAC=0
| Group | NPV, any plaque | NPV, obstructive coronary stenosis | NPV, composite all-cause death, MI or coronary revascularization |
|---|---|---|---|
| CAC=0 | 92.8% | 99.9% | 99.9% |
CAC=0
NPV, any plaque92.8%
NPV, obstructive coronary stenosis99.9%
NPV, composite all-cause death, MI or coronary revascularization99.9%
Observational data: associations, not effects.
Further findings
Age
| Outcome | CAC=0 | CAC |
|---|---|---|
| Plaque on coronary CT angiography among patients with CAC=0 | 7% | |
| Median low-attenuation noncalcified plaque burden | 4% (2-7) | — not stated in the abstract |
— not stated in the abstract
Plaque with zero CAC by risk factors
- Patients with ≥2 risk factors had higher odds of plaque with zero CAC
Original publication
Interplay Between Zero CAC, Quantitative Plaque Analysis, and Adverse Events in a Diverse Patient Cohort. Circ Cardiovasc Imaging. Published 10 August 2023. doi:10.
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