## CT Coronary angiography Reveals CAD Can Develop Even Without Traditional Risk Factors
Recent research utilizing CT coronary angiography (CTCA) indicates that coronary artery disease (CAD) can develop in individuals *without* common risk factors like high blood pressure, high cholesterol, diabetes, or smoking. A study conducted by a team at monash University in Melbourne, Australia, led by Dr. Seiyon Sivakumar, found surprisingly similar levels of coronary inflammation in these individuals compared to those *with* traditional risk factors.
The study, analyzing data from 309 patients who underwent serial CTCAs between 2010 and 2016 due to suspected stable CAD, focused on pericoronary adipose tissue (PCAT) attenuation – a measurable biomarker of coronary inflammation visible on CTCA scans. Researchers tracked PCAT attenuation around the proximal right coronary artery (PCATRCA) using specialized software, alongside assessments of plaque buildup (using segment involvement and stenosis scores) and the severity of artery narrowing based on the Coronary Artery Disease – Reporting and Data System (CAD-RADS).
Approximately 26.9% of the patients studied lacked traditional cardiovascular risk factors. Notably,patients *with* risk factors were more likely to be taking medications such as statins,ACE inhibitors/ARBs,and aspirin.
Key findings revealed that patients without risk factors exhibited a mean PCATRCA attenuation of -77.5 Hounsfield units (HU), statistically similar to the -78.4 HU observed in patients *with* risk factors (p = 0.481). This occurred despite these patients having, on average, 18.7% lower segment involvement scores (1.78 vs. 2.72, p = 0.01) and 39.5% lower segment stenosis scores (2.22 vs. 3.67, p = 0.004), indicating less plaque and narrowing. Patients with risk factors were 2.8 times more likely to have obstructive CAD (p = 0.006).
These results suggest that inflammation plays a meaningful role in CAD advancement, even in the absence of established risk factors. The researchers believe this study provides early insights into the mechanisms driving CAD in this population and highlights the potential for targeting inflammation as a therapeutic strategy.the team emphasizes the need for further research to validate these findings. The complete study was published in [Journal name – based on DOI] and is available here.
