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This exploratory retrospective cross-sectional study compared CAC scoring with coronary computed tomography angiography (CCTA) to detect subclinical CAD in 18 asymptomatic adults with risk factors. CCTA identified CAD in 72.2% (13/18) despite CAC=0 and showed higher diagnostic sensitivity.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/preliminary-observations-on-discordance-between-coronary-artery-calcium-score-of-zero-and-coronary-computed-tomography-angiography-findings-in-asymptomatic-adults/416570/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/preliminary-observations-on-discordance-between-coronary-artery-calcium-score-of-zero-and-coronary-computed-tomography-angiography-findings-in-asymptomatic-adults/416570.png","ImageObject",300,407,{"name":42,"@type":43},"Ben ","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-29","2026-09-28",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",9,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"Why might a coronary artery calcium score of zero miss coronary artery disease?","Question",{"text":63,"@type":64},"CAC scoring detects calcified plaques and may fail to identify non-calcified or soft plaques. Therefore, disease can be present even when CAC=0.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How was CCTA used in this study?",{"text":68,"@type":64},"Eighteen asymptomatic adults with CAC=0 underwent CCTA to evaluate for subclinical CAD, and risk factors and clinical/biochemical variables were assessed.",{"name":70,"@type":61,"acceptedAnswer":71},"What did the study find about diagnostic agreement between CAC and CCTA?",{"text":72,"@type":64},"CCTA detected CAD in 72.2% of participants despite no calcification on CAC. The Wilcoxon signed rank test showed a significant difference between modalities (Z = -3.606, P \u003C 0.001).","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},416570,1790716836,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":107,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":144,"preview_page_count":4},2336478951081,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Original Article Cardiol Res. 2025;16(6):518-524  \nPreliminary Observations on Discordance Between Coronary Artery Calcium Score of Zero and Coronary Computed Tomography Angiography Findingsin Asymptomatic Adults  \nFarhan Ashrafa, b, Mohammad Raza Qureshia, MasoudAlama, Sushma Umroaa,  \nShafaath Husaina, Faiz Ul Amina, Munir Khana  \nAbstract  \nBackground: Coronary artery calcium (CAC) scoring is widely used to screen for coronary artery disease (CAD) in asymptomatic individuals. However, it detects calcified plaques and may miss non-calcified or soft plaques. This study compared the diagnostic accuracy of CAC scoring with coronary computed tomography angiography (CCTA) for detecting CAD in asymptomatic individuals with risk factors.  \nMethods: Eighteen asymptomatic adults with a CAC score of 0 underwent CCTA to evaluate for subclinical CAD. Clinical, biochemical, and lifestyle risk factors were assessed. Diagnostic agreement between CAC and CCTA was analyzed using the Wilcoxon signed rank test.  \nResults: The cohort had a mean age of 51.4 ± 10.6 years, 88.8% were male, and mean body mass index (BMI) was 27.7 ± 3.6 kg/m2. Smoking (70.5%) and family history of CAD (56.25%) were prevalent. Biochemical analyses showed preserved renal function and non-diabetic glycemic profiles. Despite the absence of calcification on CAC, CCTA revealed CAD in 72.2%(13/18) of participants, detecting non-calcified plaques missed by CAC scoring. Elevated cardiac and inflammatory markers, including high-sensitivity cardiac troponin T, apolipoprotein B (apoB), and lipoprotein(a) (Lp(a)), were observed in those with positive CCTA findings. The Wilcoxon signed rank test indicated a significant difference between the modalities (Z = -3.606, P \u003C 0.001) .  \nConclusions: CCTA detected non-calcified atherosclerosis missed by CAC and demonstrated superior sensitivity for early CAD detection in asymptomatic individuals.  \nKeywords: Coronary artery disease; Coronary artery calcium scoring; Coronary computed tomography angiography; Wilcoxon signed rank test; Specificity; Sensitivity  \nManuscript submitted October 15, 2025, accepted November 21, 2025 Published online December 20, 2025  \naLife Core Private Clinic, Abu Dhabi, United Arab Emirates  \nbCorresponding Author: Farhan Ashraf, Life Core Private Clinic, Abu Dhabi,  \nUnited Arab Emirates. Email: [faht47@hotmail.com](faht47@hotmail.com)  \ndoi: [https://doi.org/10.14740/cr2151](https://doi.org/10.14740/cr2151)  \nIntroduction  \nIschemic heart disease is well known to be the most common cause of death worldwide [1] . Screening strategies for coronary artery disease (CAD) have included electrocardiography (ECG) stress test, single-photon emission computed tomography (SPECT), dobutamine stress echo, which reveal reversible stress-induced ischemia, but not necessarily the direct assessment of extent of CAD. The introduction of coronary computed tomography (CT) calcium score (coronary artery calcium (CAC)) did indirectly introduce a way to quantify extent of CAD in asymptomatic individuals [2] . The Multi-Ethnic Study of Atherosclerosis (MESA) trail identified CAC scoring as a major cardiovascular risk stratification tool, showing patients with elevated CAC score had adverse outcomes independent of traditional risk factors. A 2015 study also showed power of calcium score of 0 in predicting 15-year mortality rate [3] . However, CAC is unable to pick up on non-calcified/soft plaques. Coronary computed tomography angiography (CCTA) can pickup non-calcified disease but currently is being used only in symptomatic individuals based on guidelines [4] . We propose that in asymptomatic individuals deemed medium to high risk for CAD, screening with CCTA instead of calcium score could potentially be beneficial, both for early detection of disease, and to tailor treatment strategy based on severity of disease [5] . We examined the relationship between CAC scores of 0 and CCTA findings in asymptomatic adults with cardiovascular r","cbCaijBZe5g9h4aF","https://ap.wps.com/l/cbCaijBZe5g9h4aF","pdf",1194542,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusions\n# Introduction\n# Materials and Methods\n## Study design and population\n## Inclusion criteria\n## Exclusion criteria","[{\"question\":\"Why might a coronary artery calcium score of zero miss coronary artery disease?\",\"answer\":\"CAC scoring detects calcified plaques and may fail to identify non-calcified or soft plaques. Therefore, disease can be present even when CAC=0.\"},{\"question\":\"How was CCTA used in this study?\",\"answer\":\"Eighteen asymptomatic adults with CAC=0 underwent CCTA to evaluate for subclinical CAD, and risk factors and clinical/biochemical variables were assessed.\"},{\"question\":\"What did the study find about diagnostic agreement between CAC and CCTA?\",\"answer\":\"CCTA detected CAD in 72.2% of participants despite no calcification on CAC. The Wilcoxon signed rank test showed a significant difference between modalities (Z = -3.606, P \\u003c 0.001).\"}]","Preliminary Observations on Discordance Between Coronary Artery Calcium Score of Zero and Coronary Computed Tomography Angiography Findingsin Asymptomatic Adults | PDF",1790605887,18]