Researchers are revisiting their views on the relative dangers soft and hard atherosclerotic plaque deposits pose to heart health.
The notion that soft plaque is more likely to rupture and cause heart attacks than hard calcium deposits in coronary arteries may be wrong, according to the new study that will be presented at the American College of Cardiology Scientific Sessions in Washington, D.C., on March 18.
“We previously thought the lipid-laden soft plaque was more likely to rupture and cause heart attacks, but based on our new research, it’s more the calcified plaque that appears to be associated with adverse cardiovascular events” said Brent Muhlestein, MD, one of the study’s authors and co-director of cardiology research at the Intermountain Medical Center Heart Institute in Salt Lake City.
Intermountain Medical Center Heart Institute researchers had earlier teamed with Johns Hopkins School of Medicine and National Institutes of Health scientists to analyze the composition of plaque from 224 patients who had diabetes, but no heart symptoms.
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This new research reflects more long-term findings after patients were followed for an average of nearly seven years to see if their plaque composition had predicted whether they’d have a cardiac event.
In this study, through careful quantitative evaluation, the composition of coronary artery plaque identified in the subjects through CT coronary angiography was stratified proportionately into amounts of soft, calcified, and fibrous plaque and compared with future risk of unstable angina, heart attack or death.
Unexpectedly, proportionately higher quantities of calcified plaque best predicted major adverse coronary events, while soft plaque did not, researchers found.