Prevalence of noncalcified coronary plaques by 64-slice computed tomography in patients with an intermediate risk for significant coronary artery disease

J Am Coll Cardiol. 2006 Jul 18;48(2):312-8. doi: 10.1016/j.jacc.2006.02.064. Epub 2006 Jun 22.


Objectives: In this prospective study, we investigated the prevalence and characteristics of clearly discernible noncalcified coronary plaques in a patient population with suspected significant coronary artery disease (CAD) by using 64-slice computed tomography (CT).

Background: The assessment of noncalcified coronary plaques by noninvasive strategies may be important to improve cardiovascular risk stratification.

Methods: To rule out significant stenosis, high-resolution 64-slice coronary CT (0.6-mm collimation, 330-ms gantry rotation time) was performed in 161 consecutive patients with an intermediate risk for having CAD. Computed tomography data sets were evaluated for presence of coronary calcifications, noncalcified plaques, and/or lumen narrowing.

Results: Noncalcified coronary plaques were detected in 48 (29.8%) of 161 enrolled patients. Although noncalcified plaques together with coronary calcifications were present in 38 of 161 (23.6%) patients, the prevalence of noncalcified plaques as the only manifestation of CAD was 6.2% (10 of 161 patients). Patients with noncalcified plaques were characterized by significantly higher total cholesterol, low-density lipoprotein, and C-reactive protein levels as well as a trend for more diabetes mellitus. The majority of noncalcified plaques resulted in lumen narrowing of <50%. Of the remaining 113 patients, CAD and coronary calcifications were ruled out in 53 of 161 (32.9%) patients, whereas 60 of 161 (37.3%) patients presented with calcifications in the absence of noncalcified plaque.

Conclusions: With the use of 64-slice CT, clearly discernible noncalcified atherosclerotic coronary plaques can be detected in a large group of patients with an intermediate risk for having CAD. The assessment of these plaques by CT angiography may allow for improved cardiovascular risk stratification.

MeSH terms

  • Adult
  • Algorithms
  • C-Reactive Protein / analysis
  • Coronary Angiography
  • Coronary Artery Disease / blood
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / epidemiology
  • Coronary Stenosis / blood
  • Coronary Stenosis / diagnostic imaging*
  • Coronary Stenosis / epidemiology
  • Coronary Vessels / chemistry
  • Coronary Vessels / pathology
  • Female
  • Humans
  • Lipids / analysis
  • Male
  • Middle Aged
  • Prevalence
  • Prospective Studies
  • Risk Assessment
  • Tomography, X-Ray Computed / methods*


  • Lipids
  • C-Reactive Protein