Article

The International Journal of Cardiovascular Imaging

, Volume 28, Supplement 2, pp 93-100

First online:

Subclinical coronary atherosclerosis in young adults: prevalence, characteristics, predictors with coronary computed tomography angiography

  • Kwang Nam JinAffiliated withDivision of Cardiovascular Imaging, Department of Radiology, Bundang Hospital, Seoul National UniversityDivision of Cardiothoracic Imaging, Department of Radiology, Boramae Medical Center, Seoul Metropolitan, Seoul National University
  • , Eun Ju ChunAffiliated withDivision of Cardiovascular Imaging, Department of Radiology, Bundang Hospital, Seoul National University
  • , Chang-Hoon LeeAffiliated withDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Lung Institute of Medical Research Center, College of Medicine, Seoul National University Hospital, Seoul National University
  • , Jeong A. KimAffiliated withDivision of Cardiovascular Imaging, Department of Radiology, Bundang Hospital, Seoul National University
  • , Min Su LeeAffiliated withDivision of Cardiovascular Imaging, Department of Radiology, Bundang Hospital, Seoul National University
  • , Sang Il ChoiAffiliated withDivision of Cardiovascular Imaging, Department of Radiology, Bundang Hospital, Seoul National University Email author 

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

Abstract

The purpose of this study was to assess the characteristics and predictors of subclinical coronary atherosclerosis in young adults. The study also evaluated predictors of cardiac events. We retrospectively enrolled 914 self-referred asymptomatic subjects under the age of 45 (552 men, 362 women) who had undergone both coronary CT angiography (CCTA) and coronary artery calcium scoring. Two radiologists analyzed plaque composition and degree of stenosis. For all subjects, we evaluated clinical risk factors and investigated cardiac events. Subclinical coronary atherosclerosis was found in 86 subjects (9.4 %). Among them, 64 subjects (74.4 %) had a single coronary artery plaque. On analysis of individual segments, the most common type of plaque was non-calcified plaque (NCP) (58 %), which was found in 63 subjects (6.9 %). Significant coronary artery stenosis was found in 9 subjects (0.1 %). Predictors of subclinical coronary atherosclerosis were age, male gender, hypertension, and diabetes mellitus. Male gender, diabetes mellitus, and amount of smoking were independent predictors of NCP. High low density lipoprotein cholesterol and calcium scores were also significant predictors of stenosis. Myocardial infarction developed in 1 subject, unstable angina in 2, stable angina in 1, and death in 1 (2.45 cardiac events per 1,000 person-years of follow-up). Multivariate analysis revealed hazard ratios of 2.2 for subclinical coronary atherosclerosis, 49.17 for NCP, and 105.58 for significant stenosis. The prevalence of subclinical coronary atherosclerosis in asymptomatic young adults is not negligible. CCTA has the potential to enhance risk stratification and prediction for coronary artery disease in asymptomatic young adults.

Keywords

Coronary artery Atherosclerosis Young adults Computed tomography angiography Risk factors