Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Korea.
Heart. 2013 Aug;99(15):1113-7. doi: 10.1136/heartjnl-2013-303631. Epub 2013 May 30.
To evaluate the prevalence and characteristics of coronary atherosclerosis in asymptomatic subjects classified as low risk by National Cholesterol Education Program (NCEP) guideline using coronary CT angiography (CCTA).
An observational study.
A single tertiary referral centre.
2133 (49.2%) subjects, who were classified as low risk by the NCEP guideline, of 4339 consecutive middle-aged asymptomatic subjects who underwent CCTA with 64-slice scanners as part of a general health evaluation.
The incidence of atherosclerosis plaques, significant stenosis.
In the subjects at low risk, 11.4% (243 of 2133) of subjects had atherosclerosis plaques, 1.3% (28 of 2133) of subjects had significant stenosis, and 0.8% (18 of 2133) of subjects had significant stenosis caused by non-calcified plaque (NCP). Especially, 75.0% (21 of 28) of subjects with significant stenosis and 94.4% (17 of 18) of subjects with significant stenosis caused by NCP were young adults. Mid-term follow-up (29.3 ± 14.9 months) revealed four subjects with cardiac events: three subjects with unstable angina requiring hospital stay and one subject with percutaneous coronary intervention.
Although an asymptomatic population classified as low risk by the NCEP guideline has been regarded as a minimal risk group, the prevalence of atherosclerosis plaques and significant stenosis were not negligible. However, considering very low event rate for those patients, CCTA should not be performed in low-risk asymptomatic subjects, although CCTA might have the potential for identification of high-risk groups in the selected subjects regarded as a minimal-risk group by NCEP guideline.
使用冠状动脉 CT 血管造影术（CCTA）评估根据国家胆固醇教育计划（NCEP）指南被归类为低危的无症状患者中冠状动脉粥样硬化的发生率和特征。
观察性研究。
单中心转诊中心。
2133 名（49.2%）患者，他们根据 NCEP 指南被归类为低危患者，为 4339 名连续接受 64 层螺旋 CCTA 作为一般健康评估一部分的中年无症状患者中的一部分。
动脉粥样硬化斑块的发生率、狭窄程度。
在低危患者中，11.4%（243 例/2133 例）的患者有动脉粥样硬化斑块，1.3%（28 例/2133 例）的患者有明显狭窄，0.8%（18 例/2133 例）的患者有非钙化斑块引起的明显狭窄（NCP）。特别是，28 例明显狭窄患者中有 75.0%（21 例），18 例 NCP 引起的明显狭窄患者中有 94.4%（17 例）为年轻人。中期随访（29.3±14.9 个月）发现 4 例心脏事件：3 例不稳定型心绞痛需要住院治疗，1 例经皮冠状动脉介入治疗。
尽管根据 NCEP 指南被归类为无症状的低危人群被认为是最小风险组，但动脉粥样硬化斑块和明显狭窄的发生率并不可以忽略。然而，考虑到这些患者的极低事件发生率，对于那些被认为是 NCEP 指南中的最小风险组的选定患者，CCTA 不应该用于低危无症状患者，尽管 CCTA 可能有潜力在选定的最小风险组患者中识别高危人群。
