Calcium boosts heart attack risk. How about noncalcified plaque?

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The role of coronary artery calcium in myocardial infarction risk is well-established, but the role of noncalcified plaque is still evolving. In this study, researchers aimed to determine how total plaque burden corresponds to traditional risk factors for cardiovascular disease.

Dr. Karen Rodriguez and colleagues from the University of Michigan looked at a group of asymptomatic adults with no history of heart disease. Most previous studies have examined acute coronary syndrome patients, or patients thought to have a high coronary plaque burden.

"Noncalcified plaque is related to the ratio of LDL/HDL cholesterol, whereas the traditional calcium score and calcified plaque scores are not," Rodriguez told AuntMinnie.com.

Noncalcified plaque matters in particular because it is thought to be the modifiable component of coronary artery disease when treated by statins.

Body mass index was the main factor in elevated total plaque burden as assessed by coronary CT angiography (CCTA), independent of calcium score, the authors reported. Other factors also reached statistical significance.

"We believe that CCTA will provide a comprehensive assessment of the total plaque burden, and most importantly of noncalcified at-risk plaque," Rodriguez said.

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