Non-calcified plaque in asymptomatic patients with zero coronary artery calcium score: A systematic review and meta-analysis

Sama, Carlson, Abdelhaleem, Ahmed, Velu, Dhivya, Ditah Chobufo, Muchi, Fongwen, Noah T, Budoff, Matthew J, Roberts, Melissa, Balla, Sudarshan, Mills, James D, Njim, Tsi, Greathouse, Mark, Zeb, Irfan and Hamirani, Yasmin S (2023) 'Non-calcified plaque in asymptomatic patients with zero coronary artery calcium score: A systematic review and meta-analysis'. Journal of cardiovascular computed tomography, Vol 18, Issue 1, pp. 43-49.

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Abstract

There is growing interest in understanding the coronary atherosclerotic burden in asymptomatic patients with zero coronary artery calcium score (CACS). In this population, we aimed to investigate the prevalence and severity of non-calcified coronary plaques (NCP) as detected by coronary CT angiography (CCTA), and to analyze the associated clinical predictors. This was a systematic review with meta-analysis of studies indexed in PubMed/Medline and Web of Science from inception of the database to March 31st, 2023. Using the random-effects model, separate Forest and Galbraith plots were generated for each effect size assessed. Heterogeneity was assessed using the I statistics whilst Funnel plots and Egger's test were used to assess for publication bias. From a total of 14 studies comprising 37808 patients, we approximated the pooled summary estimates for the overall prevalence of NCP to be 10% (95%CI: 6%-13%). Similarly, the pooled prevalence of obstructive NCP was estimated at 1.1% (95%CI: 0.7%-1.5%) from a total of 10 studies involving 21531 patients. Hypertension [OR: 1.46 (95%CI:1.31-1.62)] and diabetes mellitus [OR: 1.69 (95%CI: 1.41-1.97)] were significantly associated with developing any NCP, with male gender being the strongest predictor [OR: 3.22 (95%CI: 2.17-4.27)]. There is a low burden of NCP among asymptomatic subjects with zero CACS. In a subset of this population who have clinical predictors of NCP, the addition of CCTA has a potential to provide a better insight about occult coronary atherosclerosis, however, a risk-benefit approach must be factored in prior to CCTA use given the low prevalence of NCP.

Item Type:	Article
Subjects:	WG Cardiovascular System > WG 20 Research (General) WG Cardiovascular System > Heart. Heart Diseases > WG 200 General works
Faculty: Department:	Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.1016/j.jcct.2023.10.002
SWORD Depositor:	JISC Pubrouter
Depositing User:	JISC Pubrouter
Date Deposited:	20 Feb 2024 08:22
Last Modified:	04 Mar 2024 14:29
URI:	https://archive.lstmed.ac.uk/id/eprint/23358

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