For Patients

Plaque Analysis: Understanding the Hidden Risk in Your Arteries

Plaque analysis is a modern, non-invasive method used to look directly inside the arteries of your heart to find and measure early signs of heart disease. Coronary Artery Disease (CAD) which is the buildup of plaque (atherosclerosis) in the heart's arteries, remains the leading cause of death globally.

Crucially, over 50% of individuals who die or suffer from a heart attack experience no symptoms before the event. This reality has driven the need for advanced diagnostic tools because traditional methods, which rely on risk factors like cholesterol or waiting for symptoms like chest pain, often fail to identify this dangerous disease early.

What Exactly is Plaque?

Plaque is the accumulation of cholesterol, calcium and cellular waste within the walls of your arteries.

Calcified Plaque/Hardened Plaque

Often described as pieces of calcium or "rocks" that form in the artery wall. They represent a later stage of disease and are typically considered stable plaques that usually will not rupture and are at a lower risk of directly causing a heart attack compared to other types of plaque.

Non-Calcified Plaque/Soft Plaque

This is often composed of cholesterol and cellular waste material. It is not calcified so a coronary artery calcium scan will not detect this type of plaque. This plaque type is more dangerous because it is prone to rupture, leading to blood clots in the coronary arteries. This is one of the main causes of heart attacks.

High-Risk Plaque/Low Attenuation Plaque

This is a specific subset of soft plaque, often associated with a lipid-rich core. The burden of this specific plaque type is one of the strongest predictors of fatal or non-fatal myocardial infractions
(a heart attack.)

How Plaque Analysis Works: Beyond the Basic Scan

Plaque Analysis is typically performed using a detailed heart scan called a Coronary CT Angiography (CCTA), which is a non-invasive, three-dimensional X-ray requiring a contrast agent (dye) to visualize the arteries clearly.

The Traditional Calcium Score: This older, faster scan uses CT without contrast. It only measures the hardened, calcified plaque. While useful for assessing general risk, a score of zero does not mean that you are disease-free; it simply means no hard plaque was seen, but higher-risk soft plaque could still be present.
The Advanced Plaque Analysis (AI-CCTA): This new approach uses CCTA images combined with Artificial Intelligence (AI) technology. The AI quickly and accurately measures and categorizes the total amount of plaque (Total Plaque Volume), including all of the soft and high-risk plaque that the basic calcium score misses.