Blood tests and cardiovascular risk calculators provide important information about the likelihood of cardiovascular disease.
But they cannot directly show what is happening inside the arteries that supply the heart.
The Miami Heart Study examined 1 808 adults aged 40–65 who had no cardiovascular symptoms and were not taking statins. Researchers compared LDL cholesterol and estimated cardiovascular risk with findings from CT imaging of the coronary arteries.
Among participants classified as having low cardiovascular risk, 31.5% had coronary plaque. Non-calcified plaque was present in 18.3%.
Plaque was also found in some participants with no detectable coronary calcium.
Coronary CT angiography provides a detailed view of the coronary arteries. It can detect both calcified and non-calcified plaque. It can also show whether a coronary artery has become narrowed and how severe that narrowing is.
This information can be important when the clinical picture is not fully explained by cholesterol levels, calculated cardiovascular risk or a coronary calcium score.
This does not mean that everyone should undergo coronary CT angiography.
In appropriately selected patients with cardiovascular risk factors or symptoms that raise suspicion of coronary disease, detailed coronary imaging can provide additional information that may influence further management.
Depending on the findings, this may lead to more intensive preventive treatment, additional functional testing or further evaluation with invasive coronary angiography.
The purpose is therefore not routine CT screening. It is to identify clinically important coronary disease earlier in patients for whom additional imaging is medically appropriate.
