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Q: Besides traditional risk factors for heart disease and stress testing, is there any other test out there that could assess my risk of having a heart attack in the next several years?
A: The answer is yes. Coronary artery calcium (CAC) scanning has emerged as a unique tool to detect calcium in the heart arteries.
Cardiovascular disease remains steadfast as the leading cause of death worldwide. Health care providers are continually searching for better tools to manage patients at risk for heart disease and help reduce cardiovascular mortality. Patients are increasingly aware of “traditional” risk factors of coronary heart disease which include age/gender, tobacco use, high blood pressure, high cholesterol , family history, and diabetes. However, I have often been asked if there is any other test that can help determine the risk of having a heart attack.
Conventional risk assessment tools may underestimate the risk of coronary heart disease, particularly in women and younger patients. Many patients ask if there is a way to look at their vessels for the presence or absence of coronary artery plaque build-up, the disease process that can lead to a heart attack. CAC can be measured using chest computed tomography and it is now offered at Newton Medical Center. The test takes about five minutes and uses a relatively low dose of radiation to detect the presence of calcium in the coronary arteries. Calcium in the heart arteries establishes the presence of the disease process called atherosclerosis. The volume of calcium measured by advance software technology produces a score which correlates highly with risk of future coronary heart events. A calcium score of zero assures a very low risk.
CAC scanning is an especially unique test. It has virtually no false positive rate – if calcium is detected, then it is there! And unlike traditional risk factors, coronary artery calcium is not a risk factor at all; it is actual disease. The presence of coronary calcium should prompt providers to consider more aggressive management. Sometimes, seeing is believing...depending on the patient, the test may be useful in prompting lifestyle changes which could significantly help reduce their risk such as quitting cigarette smoking, eating a heart healthy diet, and exercising regularly.
However, CAC scanning is not for everyone. If you are considered “high risk” for heart disease, evidenced based guidelines suggest aggressive management, as if the disease is already present. If you are “low risk” for heart disease, then a calcium score is unlikely to add value. If you fall in the middle, this is where CAC scanning tends to be most valuable. Your risk level can be determined by your primary provider or Cardiologist based on traditional risk factor assessment. They can determine if you are a good candidate for the scan.
Patients require a prescription for CT Calcium Score from their physician. They may call the Newton Medical Center radiology department at 973-579-8720 to schedule an appointment. The fee is $99, paid at the time of service and is not covered by insurance. Results will be sent to the ordering physician within 24-48 hours of the exam.
Cindy Codispoti, DO, is a cardiologist at Newton Medical Center.