Scientists are revisiting their views on the dangers hard and soft atherosclerotic plaque deposits pose to heart health. Discoveries of new research by scientists at the Intermountain Medical Center Heart Institute may be a “game-changer” for determining who’s at risk of a heart attack.
The idea that soft plaque is more likely to rupture and cause heart attacks than hard calcium deposits in coronary arteries may be false, according to new research. Atherosclerosis is caused when plaque builds up in the arteries, narrowing and hardening them.
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 stated, “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.”
Intermountain Medical Center Heart Institute scientists had earlier associated with Johns Hopkins School of Medicine and National Institutes of Health scientists to test the composition of plaque from 224 patients who had diabetes, but no heart symptoms.
The new study reflects more long-term discoveries 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 the research, the structure of coronary artery plaque discovered 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, subsequently increased quantities of calcified plaque best predicted major adverse coronary events, while soft plaque did not, scientists discovered. Dr. Muhlestein said further studies are needed to verify the findings, but results from his team’s research may represent a potential paradigm shift. He stated, “We need further validation to gauge the importance of why the coronary calcium score is so predictive.”