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A coronary artery calcium (CAC) score of zero generally portends lower cardiovascular risk, but two new studies raise questions about its predictive value in symptomatic patients.
In the first study, investigators analyzed plaque characteristics on clinically indicated CT angiograms (CTA) from 108 symptomatic patients who subsequently developed an acute coronary syndrome (ACS) during an average 3.4 years of follow-up and a matched group of 108 symptomatic patients who did not. Almost one quarter in each group had a CAC of zero on CTA; among these patients, noncalcified plaque volumes were significantly greater in those who subsequently developed ACS than in those who did not.
In the second study, which involved 24,000 indivi…