Signs Of Atherosclerosis in Adults: Cardiac CT scan is a widely used approach to identify people who are at risk for heart disease. But it can miss those with non-calcified atherosclerosis, a major cause of heart attacks.
Atherosclerosis is a major cause of heart attacks. It is the buildup of fatty deposits inside your arteries, which can restrict blood flow to the heart and lead to blood clots, heart attack or stroke. Unfortunately, in most cases, atherosclerosis shows no symptoms until an artery is very narrow or entirely blocked or until you have a heart attack or stroke.
Silent coronary atherosclerosis is common among middle-aged adults, and it increases sharply with sex, age and other risk factors. But a new study has found the prevalence of atherosclerosis in many adults without established heart disease.
In a study of more than 25,000 adults in Sweden, more than 40% of middle-aged adults with no known heart disease were found to have some degree of atherosclerosis. In more than 5%, the buildup of fatty deposits narrowed at least one artery by 50% or more. The narrowing was so severe in nearly 2% of people with atherosclerosis that blood flow was obstructed to large portions of the heart, revealed the study published in the American Heart Association’s flagship journal Circulation.
Screening for heart disease
Cardiac computed tomography, commonly known as a cardiac CT scan, is a widely used approach to identify people who are at risk for heart disease but who do not yet have symptoms. It measures the presence and density of calcium-containing plaque in the coronary arteries. Based on these scans, individuals are given a coronary artery calcification (CAC) score to estimate their risk for or extent of coronary artery disease. A person with a CAC score of 400 or higher is known to have a high risk for having a heart attack, stroke or dying from either one within the next 10 years. However, cardiac CT scan can miss those who are at risk for heart attack even though they have a zero CAC score.
Measuring the amount of calcification is important, but it can’t help in identifying non-calcified atherosclerosis, which also increases heart attack risk, noted study author G ran Bergstr m from the University of Gothenburg’s Institute of Medicine in Gothenburg, Sweden. He is a professor and senior consultant in clinical physiology in the department of molecular and clinical medicine at the University.
Bergstr m and colleagues randomly recruited 25,182 participants aged 50 — 64 years old who had no history of a prior heart attack or cardiac intervention. They underwent both CAC scans and coronary computed tomography angiography (CCTA) scans. CCTA is a radiologic technique that can provide a very detailed image of the inside of the arteries that supply blood to the heart.
CAC scans Vs CCTA scans
In more than 42% of the study participants, CCTA detected some degree of atherosclerosis. In 5.2% of those with atherosclerosis, the build-up obstructed blood flow through at least one coronary artery by 50% or more.
Nearly 2% had even more severe atherosclerosis, wherein blood flow was obstructed to the main artery that supplies blood to large portions of the heart. In some cases, CCTA found that all three coronary arteries were obstructed.
Those with higher degree of atherosclerosis seen by CCTA also had higher CAC scores. Nearly half of those with a CAC score above 400 had significant blockage, where blood flow was obstructed in one of the coronary arteries by more than 50%. However, CCTA detected atherosclerosis in 5.5% of those with a CAC score of zero, and 0.4% of them had significant obstruction of blood flow.
Use of CCTA in heart attack prevention
Suggesting the use of CCTA in heart attack prevention, Bergstr m said that one main advantage of CCTA is that it can detect not-yet calcified atherosclerosis. “We found that 8.3% of the adults had one or more non-calcified plaques. Non-calcified atherosclerosis is believed to be more prone to cause heart attacks compared with calcified atherosclerosis,” Bergstr m said, as quoted by ScienceDaily.
In addition, the study found that compared to men, atherosclerosis started an average of 10 years later in women. The buildup of fatty deposits inside your arteries was found to be 1.8 times more common in people ages 60-64 than those ages 50-54.
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This post first appeared on The Health Site