Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access
Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc
Journal website https://cr.elmerpub.com

Original Article

Volume 16, Number 6, December 2025, pages 518-524

Preliminary Observations on Discordance Between Coronary Artery Calcium Score of Zero and Coronary Computed Tomography Angiography Findings in Asymptomatic Adults

Figures

↓  Figure 1. Coronary artery assessment based on CCTA findings in the study population (n = 18). Positive CCTA results were observed in 13 patients (72.2%), including minimal stenosis in 38.8% and mild stenosis in 33.3%. Negative findings were present in five patients (27.7%), with no plaques or stenosis detected. CCTA: coronary computed tomography angiography; +ve: positive; -ve: negative.
Figure 1.
↓  Figure 2. The diagnostic comparison between CAC scoring and CCTA in 18 asymptomatic individuals. All patients had a CAC score of 0, suggesting no coronary artery disease. However, subsequent CCTA revealed that 13 out of 18 individuals had significant coronary artery disease. A Wilcoxon signed rank test demonstrated statistically significant difference between the two diagnostic modalities (Z = -3.606, P < 0.001). CAC: coronary artery calcium; CCTA: coronary computed tomography angiography.
Figure 2.
↓  Figure 3. (a) Bar chart showing the comparison of CAC score and CCTA in detecting CAD. (b) Curve showing the percentage of patients with stenosis. CAC: coronary artery calcium; CAD: coronary artery disease; CCTA: coronary computed tomography angiography.
Figure 3.

Tables

↓  Table 1. Basic Demographic Information of the Participants
 
CharacteristicValue
BMI: body mass index.
Age (years)51.4 ± 10.6
Male16 (88.8%)
Female2 (11.1%)
BMI (kg/m2)27.7 ± 3.6
Normal (BMI ≤ 25)4 (22.2%)
Overweight (25 < BMI ≤ 30)11 (64.7%)
Obese (BMI ≥ 30)2 (11.7%)
Ethnicity (Asian)5 (29.4%)
Ethnicity (White)11 (64.7%)
Ethnicity (Black)1 (5.8%)

 

↓  Table 2. Lifestyle Factors Information of the Participants
 
CharacteristicValue
CAD: coronary artery disease.
Smoker12 (70.5%)
Alcoholic6 (35.2%)
Positive family history for CAD9 (56.25%)
Diabetes2 (11.76%)
Body fat percentage (19-30%)5 (29.4%)
Body fat percentage (30-40%)5 (29.4%)
Body fat percentage (40-51%)5 (29.4%)
Dietary habits (low carbohydrate)6 (35.2%)
Dietary habits (high carbohydrate)2 (11.76%)
Physical activity level (low)5 (29.41%)
Physical activity level (high)12 (70.58%)

 

↓  Table 3. Medical History of the Participants
 
CharacteristicValue
History of kidney disease0
History of autoimmune disease0
History of sleep apnea8 (47.05%)
History of hypertension7 (41.17%)

 

↓  Table 4. Biochemical Markers
 
CharacteristicValue
LDL: low-density lipoprotein; HDL: high-density lipoprotein; HOMA-IR: homeostatic model assessment for insulin resistance; apoB: apolipoprotein B; Lp(a): lipoprotein(a); eGFR: estimated glomerular filtration rate; HbA1c: glycated hemoglobin; CD: cluster of differentiation; anti-TPO: anti-thyroid peroxidase; RDW-CV: red blood cell distribution width-coefficient of variation; VO2 max: maximal oxygen consumption; hs-CRP: high-sensitivity C-reactive protein.
Creatinine (mg/dL)1.16 ± 0.5
Urea (mmol/L)9.36 ± 2.70
eGFR (mL/min)115 ± 14.34
LDL (mg/dL)125.6 ± 52.96
HDL (mg/dL)54.3 ± 11.99
Lp(a) (nmol/L)71.33
HbA1c5.35 ± 0.4
High-sensitivity cardiac troponin T (pg/mL)18.91 ± 5.05
apoB (mg/dL)100.91 ± 34.28
hs-CRP (mg/L)1.61 ± 1.35
Homocysteine (µmol/L)10.41 ± 2.76
CD28 (cells/µL)1.94 ± 0.56
CD25 (cells/µL)1.72 ± 0.65
RDW-CV (%)13.4 ± 1.2
Triglycerides (mg/dL)90.01 ± 24.96
Uric acid (mg/dL)4.11 ± 0.92
HOMA-IR0.78 ± 0.95
Anti-TPO (IU/mL)25.22 ± 27.57
Copper (µg/dL)67.5 ±15.77
VO2 max (mL/kg/min)30 ± 10

 

↓  Table 5. Distribution of Different Coronary Artery Disease (Stenosis %) Subgroups in Relation to the Total Number of Patients %
 
Coronary artery disease (stenosis %)Total number of patients (%)
None (0%)5 (27.7%)
Minimal (1-24%)7 (38.8%)
Mild (25-49%)6 (33.3%)
Moderate (50-69%)0