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Heart Attack Risk Game-Changer

Turns out that soft plaque may not actually be more likely to rupture and cause heart attacks than hard calcium deposits in coronary arteries.

There is plenty of discussion regarding which individuals are at a disproportionately high risk for heart attacks. After all, some seemingly healthy people endure heart attacks while many individuals who are out of shape aren’t saddled with such a tragedy. Medical researchers have recently revisited the relative risks that hard and soft atherosclerotic plaque deposits pose to the human heart. A study conducted by researchers at the Intermountain Medical Center Heart Institute produced findings that might prove quite important in the quest to determine who, exactly, is at the highest risk for a heart attack. The study’s findings were presented earlier this month in Washington D.C. at the American College of Cardiology Scientific Sessions.

Study Details

The above referenced study determined that soft plaque might not be as likely to rupture and cause heart attacks as once thought. Researchers now believe such soft plaque and hard calcium deposits within coronary arteries might be equally likely to spur a heart attack. Some believe hard calcium deposits are more likely to trigger a heart attack. Atherosclerosis is triggered when plaque accumulates in the arteries, causing them to narrow and eventually harden. It was previously thought that soft plaque with lipids (fats) was most likely to rupture and induce a heart attack. However, additional research shows that calcified plaque is linked to heart troubles.

The study built on analysis of plaque composition performed by Salt Lake City’s Intermountain Medical Center Heart Institute and the National Institutes off Health scientists. These groups studied the plaque composition of 224 patients who suffered from diabetes but did not have heart symptoms. The latest research provides long-term findings by following patients for an average of just under seven years to determine if plaque composition could predict cardiac arrest or other heart problems.

The researchers performed nuanced quantitative evaluations to pinpoint subjects’ coronary artery plaque with CT coronary angiography. It was then stratified to amounts of fibrous, soft and calcified plaque and compared with the risk for heart attack, angina or death. The research team was surprised to find that the best predictor of significant adverse coronary events was particularly high quantities of calcified plaque. It appears as though soft plaque might not be as strong of a predictor of such adverse coronary events.

Additional Study is Necessary

The study’s authors indicate that future analysis must be performed to verify the legitimacy of the latest findings. However, the findings produced by the study indicate that the paradigm could shift, favoring coronary calcium score as an excellent predictor of heart trouble. Though such an accumulation of coronary calcium does not disappear, doctors can treat patients with statins. Furthermore, coronary calcium does not develop unless plaque exists. This means individuals with coronary calcium also have atherosclerosis. It appears as though hard calcium deposits are a true disease marker rather than a risk marker.

It is possible that the finding means that many patients will not require statin therapy even though they are plagued by high cholesterol. Additional research will help doctors determine if a coronary calcium score can help pinpoint the exact individuals who should be treated. The next step is for more scans to be performed. If the findings hold true, they will be considered legitimate and prove to be quite the game-changer in the context of heart attack risk and prevention.

Intermountain Medical Center

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