Frequency and risk factors associated with atherosclerotic plaques in patients with a zero coronary artery calcium score.

Analysis of the coronary artery calcium levels usually provides important information that can be used in patient prognosis and stratification of treatment when coronary artery disease is suspected. However, plaques, with or without significant stenosis, have been reported in patients without coronary artery calcium. The aim of this study was to determine the frequency and risk factors of the development of coronary artery plaques in individuals with a zero calcium score.Analysis of coronary artery calcium levels and coronary computed tomography angiography (CTA) were performed using 64-slice computed tomography (CT). The demographic data, clinical risk factors, and imaging features of 519 consecutive patients (54 ± 10 years, male:female ratio of 56:44) were retrospectively analyzed. The presence of plaques and the degree of the resulting stenosis were recorded. Descriptive, univariate, and multivariate analyses were carried out to identify the frequency and risk factors associated with the presence of coronary artery plaques.Among 66 patients, 82 coronary arteries were found to have plaques, and six coronary arteries showed significant stenosis. Univariate analysis showed that an age greater than 55 years, male gender, a body mass index (BMI) of more than 27, hypertension, and diabetes mellitus are significant factors associated with the development of coronary artery plaques. Multivariate logistic regression analysis showed that an age over 55 years (p = 0.012, OR = 2.13, 95% C.I. = 1.18-3.84) and BMI greater than 27 (p = 0.026, OR = 2.01, 95% C.I. = 1.09-3.72) are independent factors associated with the presence of plaques in patients with a zero calcium score.The results of this study show that plaques are present in a significant proportion of individuals with a zero coronary artery calcium score. In addition, advanced age and obesity are risk factors associated with the development of plaques.