Coronary Artery Calcium Scoring Reveals Early-Stage Heart Disease

Are you a heart attack waiting to happen? With a simple X-ray procedure that takes between five and 10 minutes to complete, you can know the answer.

Called coronary artery calcium scoring, the non-invasive diagnostic procedure is considered the single most accurate method to predict your risk of developing coronary artery disease (CAD).

CAD occurs when fatty deposits build up along the arteries that supply blood to the heart muscle. The fatty deposits thicken and enlarge over your lifetime, resulting in atherosclerosis. Atherosclerosis causes the arteries to become narrow, and can decrease or block the flow of blood to the heart.

Predicting Heart Attack and Stroke

“Atherosclerotic cardiovascular disease is the major cause of heart attacks leading to one in three deaths in the United States,” says cardiologist George Farah, MD. “Robust clinical evidence suggests that calcium scoring is the most useful tool in predicting a patient’s risk of cardiovascular death, myocardial infarction and stroke.”

The test looks for specks of calcium – or calcifications – in the walls of the coronary arteries, while you lie inside a computed tomography (CT) imaging machine, Dr. Farah says. Calcifications are an early sign of coronary artery disease.

The CT images shows the presence and extent of calcium deposits in plaque on the walls of your heart’s arteries. Scores can range from:

  • 0: No calcium is seen, and there is a very low risk – less than 1 percent – of having a heart attack over the next 10 years
  • 1-99: Low risk of a heart attack in the next 10 years
  • 100-399: Moderate risk of developing atherosclerosis and artery blockages over the next 10 years
  • 400 or greater: High risk of suffering a cardiac event in the next 10 years

“Depending on your score, your doctor may recommend lifestyle measures and medications to lower your disease risk,” Dr. Farah says. “If your calcium score is high, this is a warning that extensive hardening of the arteries may be present and aggressive prevention strategies should be used.”

Who Should Have a Calcium Score Test?

The calcium score test is recommended for men age 45 or older and women age 55 or older who do not have a history of coronary artery disease. In addition, you should have one or more risk factors for heart disease, such as:

  • High blood cholesterol
  • Low HDL cholesterol (the “good” cholesterol)
  • High blood pressure
  • Cigarette smoking
  • Type 2 diabetes
  • A family history of heart disease

One group that benefits from calcium scoring are patients with chronic inflammatory disease.

“In the past, predicting their risk of cardiovascular disease was challenging,” Dr. Farah says.

If you're age 40 or older and have been diagnosed with a chronic inflammatory condition, such as inflammatory bowel disease, lupus, rheumatoid arthritis, ankylosing spondylitis or psoriasis, you should be tested.

How to Get a Free Calcium Score Test

In the past, very few patients had the test done as it is generally not covered by insurance and was quite costly. However, University Hospitals Harrington Heart & Vascular Institute now offers the calcium scoring test at no cost.

Call or have your doctor call Radiology Patient Access at 216-844-1700 to arrange for a test. A physician order is required to schedule.

George Farah, MD, is a cardiologist at UH Harrington Heart & Vascular Institute. You can request an appointment with Dr. Farah or any other University Hospitals doctor online.

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