Posted on Jul 22, 2022, 3 p.m.
Article courtesy of Dr. Joel Kahn, MD, who is a Clinical Professor of Medicine at Wayne State University School of Medicine, one of the world's top cardiologists, best-selling author, lecturer, and a leading expert in plant-based nutrition and holistic care.
Many people without any known heart disease or heart symptoms may still have blocked arteries full of atherosclerotic plaque. Early detection of coronary artery disease (CAD) using coronary computed tomography angiography (CCTA), in addition to coronary artery calcification (CAC) scoring could detect the presence and severity of CAD even in those with no known issues on clinical grounds. A large study in Sweden used CCTA to determine the prevalence, severity, and characteristics of CAD and its association with CAC scores in a general population.
The researchers recruited individuals aged 50 to 64 years to have an assessment of silent CAD. The study includes individuals without known CAD (ie, no previous myocardial infarctions or cardiac procedures). CT mages were scored for CAC. CCTA images were visually read and scored for CAD per segment (defined as no atherosclerosis, 1% to 49% narrowing, or ≥50% narrowing).
In total, 25 182 individuals without known coronary heart disease were included (51% women). Any CCTA-detected CAD was found in 42%. Any significant narrowing (≥50%) was found in 5.2%; more serious locations of narrowing in the left main, proximal left anterior descending artery, or 3-vessel CAD was found in 2%; and any noncalcified plaques in 8.3% of the population.
The onset of CAD was delayed on average by 10 years in women. CAD was more prevalent in older individuals and predominantly found in the proximal left anterior descending artery. Prevalence of CCTA-detected atherosclerosis increased with increasing CAC scores. Among those with a CAC score >400, all had atherosclerosis and 46% had significant narrowing. In those with 0 CAC, 6% had atherosclerosis but only 0.4% had significant narrowing.
Using CCTA in a large sample of the general population without established CAD, silent coronary atherosclerosis was common and found in 42% that did not know they had any CAD. High CAC scores over 400 convey a significant probability of substantial stenosis, and 0 CAC does not exclude CAD from non-calcified soft plaque. So if you feel fine, congratulations, but you may still have CAD. Test Not Guess by at least a CAC score and possibly a CCTA.
About the author: At his core, Dr. Joel Kahn believes that plant-based nutrition is the most powerful source of preventative medicine on the planet. Having practiced traditional cardiology since 1983, it was only after his own commitment to a plant-based vegan diet that he truly began to delve into the realm of non-traditional diagnostic tools, prevention tactics, and nutrition-based recovery protocols.
As with anything you read on the internet, this article should not be construed as medical advice; please talk to your doctor or primary care provider before changing your wellness routine.
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