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It questions the reliability of zero coronary calcium in high-risk subgroups like familial hypercholesterolemia, high Lp(a), and the young. While CCTA can accurately visualize non-calcified plaque, its interpretation requires expertise and clinical judgment should consider both imaging and clinical risk factors for management. Advanced plaque quantification, peri-coronary (PCAT), and epicardial (EAT) adipose tissue could help better-stratified patients but the evidence-based clinical application remains unknown.<\/jats:p>","DOI":"10.1007\/s10554-024-03216-6","type":"journal-article","created":{"date-parts":[[2024,8,13]],"date-time":"2024-08-13T18:02:24Z","timestamp":1723572144000},"page":"2221-2225","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Rapidly progressive coronary atherosclerosis in a young male: a retrospective advanced CCT phenotype analysis"],"prefix":"10.1007","volume":"40","author":[{"given":"Daniel","family":"Lorenzatti","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annalisa","family":"Filtz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Azeem","family":"Latib","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"DeRose","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damini","family":"Dey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel S.","family":"Berman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario J.","family":"Garcia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leandro","family":"Slipczuk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,8,13]]},"reference":[{"issue":"12","key":"3216_CR1","doi-asserted-by":"publisher","first-page":"1573","DOI":"10.1093\/ehjci\/jeac192","volume":"23","author":"B Szilveszter","year":"2022","unstructured":"Szilveszter B, Kolossv\u00e1ry M, Pontone G, Williams MC, Dweck MR, Maurovich-Horvat P (2022) How to quantify coronary atherosclerotic plaque using computed tomography. 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Damini Dey received grant support from the National Heart, Lung, and Blood Institute, software royalties from Cedars-Sinai Medical Center, and hold a patent (US8885905B2in USA and WO patent WO2011069120A1, Method and System for Plaque Characterization). Others have nothing to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}