Coronary CT angiography may be useful to detect ‘silent’ atherosclerosis in middle-aged adults, including those with a calcium score of zero, clinicians say.

Swedish researchers conducted a prospective, population-based study of patients without known coronary heart disease, which showed more than 40% of adults aged 50-64 had plaque.

Although coronary artery calcium (CAC) scoring remained a valuable diagnostic aid, they suggested coronary CT angiography (CCTA) could further refine absolute CVD risk stratification.

“Measuring the amount of calcification is important, yet it does not give information about non-calcified atherosclerosis, which also increases heart attack risk,” said lead author Professor Göran Bergström, from the University of Gothenburg.