IMO 34.6% is a surprisingly high number, especially in that age range. Most men in their 30's would have a CAC of 0, so being able to observe soft plaque through these newer imaging modalities is telling us something genuinely new.

Whether that's good or bad isn't fully known. We'd expect it's bad: soft plaque is more likely to rupture than hard plaque.

But the study itself measured plaque in a cross-section of participants, at a moment in time. To get a definitive answer, we'd need to follow participants for several decades, observe a large number events (heart attacks, strokes, etc) and then see if soft plaque is predictive above and beyond conventional risk scores.

One thing that struck me about this particular study is that they used two different imaging techniques (CCTA and ultrasound) to measure soft plaque. (This is necessary to capture both coronary and peripheral arteries.)

This post is from a business that performs blood testing $$$.