22 Aug 2025 • A study of 23,777 symptomatic individuals with a coronary artery calcium score of zero (CAC=0) showed that elevated LDL cholesterol still conferred significant cardiovascular risk.

Non-calcified plaques were present in 11% of patients, with each 1 mmol/L rise in LDL-C increasing plaque odds by 21%, most pronounced in those ≤45 years (aOR 1.39).

Over 7.1 years, 299 participants (1%) experienced coronary heart disease events, with each 1 mmol/L rise in LDL-C raising risk by 28% (aHR 1.28), and even more in younger adults (aHR 1.37 at ≤45 years).

These findings highlight that CAC=0 does not eliminate risk and underscore the need for aggressive lipid management, particularly in younger populations.

Source: Oxford Academic | Read Full Story