Eicosapentaenoic acid to arachidonic acid (EPA/AA) ratio as an associated factor of high risk plaque on coronary computed tomography in patients without coronary artery disease.

•This paper focused on the primary prevention of coronary artery disease (CAD).•High risk plaques (HRP) on CCTA was related with low EPA/AA in patients without previous CAD.•EPA/AA had incremental value over CT parameters such as coronary calcium score, number of vessel disease, and plaque burden as well as conventional risk factors to predict HRP on CCTA.•Male, number of vessel disease, and HRP were independent predictors of cardiovascular events.