Study Finds Smarter Predictions for Heart Attack Risk

Density of calcified plaque provides new clues

plaque in artery illustration

When plaque calcifies inside the coronary arteries, it puts you at higher risk for heart attack or stroke. A new study finds that knowing just how dense these plaques are may help doctors better predict who is at greater risk for a cardiovascular event.

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Researchers at the University of California-San Diego studied computed tomography (CT) scans of men and women ages 45 to 84. They followed the study participants for 10 years. Their research focused on the calcified plaques in participants’ coronary arteries.

The researchers found that those with denser calcified plaques were more protected from heart attack and stroke. This finding suggests that calcified plaques that are more dense are also more resistant to rupturing.

“While plaques in our arteries should always be avoided, this study suggests that denser plaques are the lesser of two evils,” says cardiologist David Frid, MD. “With denser plaques, you’re less at risk of a cardiovascular event.”

Avoiding plaques

The study findings don’t suggest that people generally need CT scans, Dr. Frid says. He says measuring calcified plaque in your heart’s arteries with this test is typically reserved for high-risk patients.

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“People shouldn’t feel that they need to run out and get a CT scan, which isn’t necessary for most patients,” Dr. Frid says. “The test should only be only used in certain, specific situations at the advice of your doctor.”

He advises patients that the best way to reduce risk for heart attack or stroke is to avoid plaque formation altogether.

“Focusing on plaque density is not as helpful as looking at key behaviors that put you at risk for developing plaques in the first place,” he says.

So what can you do to avoid plaques? Not surprisingly, the list is also a formula for good health: Don’t smoke, eat a healthy diet, exercise and maintain a good weight.

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“If you have diabetes, hypertension or high cholesterol, it’s also important to keep these under control,” Dr. Frid says.

How plaques form

When fat builds up inside your arteries, it slightly injures the blood vessel walls, Dr. Frid says. In an attempt to heal the blood vessel walls, the cells release chemicals that make the blood vessel walls stickier. Other substances traveling through the blood stream, such as calcium, begin to adhere to the vessel walls. The fat and other substances combine to form plaque.

Many of the plaques are soft on the inside with a hard fibrous covering. If the plaque ruptures, a blood clot can form on its surface. A heart attack or stroke can occur when a large blood clot blocks blood flow through a coronary artery.

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