More than 40% of adults with no known heart disease had fatty deposits
in heart arteries

Date:
September 20, 2021
Source:
American Heart Association
Summary:
More than 40% of middle-aged adults with no known heart disease had
signs of atherosclerosis, a buildup of fatty deposits that reduce
blood flow to the heart, in a study of more than 25,000 adults in
Sweden. In more than 5% of the people who had a buildup of fatty
deposits, the atherosclerosis narrowed at least one artery by 50%
or more. In nearly 2% of the people with artery deposits, the
narrowing was so severe that blood flow was obstructed to large
portions of the heart.



FULL STORY ==========================================================================
More than 40% of adults ages 50 to 64 years in Sweden without known heart disease were found to have some degree of atherosclerosis, according to
a new study published today in the American Heart Association's flagship journal Circulation.


========================================================================== Atherosclerosis, or the buildup of fatty deposits in blood vessels that
supply blood to the heart, is a major cause of heart attacks. A widely
used approach to screen people who are at risk for heart disease but
who do not yet have symptoms is cardiac computed tomography, commonly
known as a cardiac CT scan, for coronary artery calcification (CAC)
scoring. The scan creates cross- sectional images of the vessels that
supply blood to the heart muscle to measure the presence and density
of calcium-containing plaque in the coronary arteries. Based on these
scans, individuals are given a CAC "score" to estimate their risk for or
extent of coronary artery disease. This score can be 0 to over 400. A CAC
score of 400 or higher is associated with a high risk for having a heart attack, stroke or dying from either one within the next 10 years. However,
CAC scoring can miss a percentage of people who are at risk for heart
attack even though they have a zero CAC score.

"Measuring the amount of calcification is important, yet it does not give information about non-calcified atherosclerosis, which also increases
heart attack risk," said study author Go"ran Bergstro"m, M.D., Ph.D.,
professor and senior consultant in clinical physiology in the department
of molecular and clinical medicine at the University of Gothenburg's
Institute of Medicine in Gothenburg, Sweden.

Bergstro"m and colleagues randomly recruited participants aged 50 --
64 years old from the Swedish census register from 2013 to 2018 as part
of the Swedish CArdioPulmonary BioImage Study (SCAPIS). They report on
data from 25,182 participants with no history of a prior heart attack or cardiac intervention who underwent both CAC scans and coronary computed tomography angiography (CCTA) scans . CCTA is a radiologic technique that
gives a very detailed image of the inside of the arteries that supply
the heart with blood. The researchers wanted to determine the prevalence
of atherosclerosis in the general population without established heart
disease, and how closely the CCTA findings correlated to CAC scores.

They found:
* CCTA detected some degree of atherosclerosis in more than 42% of the
study participants.

* CCTA found that in 5.2% of those with atherosclerosis, the build-up
obstructed blood flow through at least one coronary artery (out
of three) by 50% or more.

* In nearly 2% of those found to have artery build-up, the
atherosclerosis
was even more severe. Blood flow was obstructed to the main artery
that supplies blood to large portions of the heart, and in some
cases, all three coronary arteries were obstructed.

* Atherosclerosis started an average of 10 years later in women
compared to
men.

* Atherosclerosis was 1.8 times more common in people ages 60-64
vs. those
ages 50-54.

* Participants with higher levels of atherosclerosis seen by CCTA
also had
higher CAC scores.

* Of those with a CAC score of more than 400, nearly half had
significant
blockage, where more than 50% of the blood flow was obstructed in
one of the coronary arteries.

* In those with a CAC score of zero, 5.5% had atherosclerosis
detected by
CCTA, and 0.4% had significant obstruction of blood flow.

"The current, 2019 American Heart Association/American College of
Cardiology guideline for prevention of heart attacks states that adults
with a zero CAC score and intermediate level of risk factors are at low
risk of future heart attack. We found that 9.2% of people who fit that description had atherosclerosis in their coronary arteries visible by
CCTA," Bergstro"m said.

"One strength of CCTA is that not-yet calcified atherosclerosis can be detected. 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." The AHA/ACC guideline Bergstro"m mentions does not address the use of CCTA in heart
attack prevention.

"It is important to know that silent coronary atherosclerosis is common
among middle-aged adults, and it increases sharply with sex, age and risk factors," according to Bergstro"m. "A high CAC score means there is a
high likelihood of having obstruction of the coronary arteries. However,
more importantly, a zero CAC score does not exclude adults from having atherosclerosis, especially if they have many traditional risk factors of coronary disease." A limitation of the study is that it lacks follow-up information about how cardiovascular heart disease develops in this
population, which makes it impossible to determine if these findings
predict clinical heart disease in this population.

========================================================================== Story Source: Materials provided by American_Heart_Association. Note:
Content may be edited for style and length.


========================================================================== Journal Reference:
1. Go"ran Bergstro"m, Margaretha Persson, Martin Adiels, Elias
Bjo"rnson,
Carl Bonander, Haakan Ahlstro"m, Joakim Alfredsson, Oskar Angeraas,
Go"ran Berglund, Anders Blomberg, John Brandberg, Mats Bo"rjesson,
Kerstin Cederlund, Ulf de Faire, Olov Duvernoy, O"rjan Ekblom,
Gunnar Engstro"m, Jan E. Engvall, Erika Fagman, Mats Eriksson, David
Erlinge, Bjo"rn Fagerberg, Agneta Flinck, Isabel Gonc,alves, Emil
Hagstro"m, Ola Hjelmgren, Lars Lind, Eva Lindberg, Per Lindqvist,
Johan Ljungberg, Martin Magnusson, Maria Mannila, Hanna Markstad,
Moman A. Mohammad, Fredrik H. Nystrom, Ellen Ostenfeld, Anders
Persson, Annika Rosengren, Anette Sandstro"m, Anders Sja"lander,
Magnus C. Sko"ld, Johan Sundstro"m, Eva Swahn, Stefan So"derberg,
Kjell Tore'n, Carl Johan O"stgren, Tomas Jernberg. Prevalence
of Subclinical Coronary Artery Atherosclerosis in the General
Population. Circulation, 2021; 144 (12): 916 DOI: 10.1161/
CIRCULATIONAHA.121.055340 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2021/09/210920082142.htm

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