Coronary computed tomography angiography (CCTA) can help identify atherosclerosis among middle-aged patients with no known heart disease, according to a new analysis published in Circulation.

Researchers analyzed data from 30,154 study participants between the ages of 50 and 64 years. All patients were based in Sweden, and 50% were women. 

For 25,182 study participants, the team had access to CCTA results. They identified signs of coronary atherosclerosis in 42.1% of those participants and significant stenosis in another 5.2%.

More severe forms of coronary atherosclerosis were not as common, showing up in the CCTA results of just 1.9% of participants. One or more non-calcified plaques were detected in 8.3%.

In addition, disease onset was delayed by 10 years in women and a higher prevalence of coronary atherosclerosis was seen in older participants.

According to the authors, participants with high coronary artery calcification (CAC) scores (any score greater than 400) had atherosclerosis, and 45.7% of those patients had considerable stenosis.

Of the participants with a CAC score of 0, 5.5% presented with atherosclerosis and 0.4% had significant stenosis. In participants who had a score of 0 and an intermediate 10-year risk of atherosclerotic cardiovascular disease, 9.2% had CCTA-verified atherosclerosis.

“I would say that the main takeaway is that we now have firm knowledge on how common it is with atherosclerosis in the general, asymptomatic population (42%) and that 5% actually have obstructive disease (>=50% stenosis) but still without symptoms,” lead author Göran Bergström, MD, PhD, with the department of molecular and clinical medicine at the University of Gothenburg in Sweden, told Cardiovascular Business. “These data form the basis for future risk prediction models. We also see that CCTA brings additional information beyond calcium scoring.”