What's a Coronary Artery Calcium Scan?
Predicting heart attack risk among people at mid-risk for heart disease is most effective with a heart calcium scan, according to a new study.
By Jaimie Dalessio Clayton
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WEDNESDAY, August 22, 2012— You may get hung up on your cholesterol levels or how well your ticker performed on your last stress test, but scoring well on those evaluations doesn't always equal a clean bill of health. A person with high cholesterol can have "squeaky clean vessels," says Arthur Agatston, MD, a preventive cardiologist and creator of the South Beach Diet, while a person with a normal stress test can die of a heart attack.
Among the millions of Americans classified at intermediate risk for heart disease, coronary artery calcium scans are the most effective at predicting actual risk of heart attack or stroke, according to a study published Wednesday in theJournal of the American Medical Association (JAMA).
Dr. Agatston has worked with heart calcium scans for more than 20 years (he did his first one in 1988), so I picked his brain to find out more about the tests.
What Do Heart Calcium Scans Measure?
The calcium score is measured by taking a computed tomography (CT) scan of the heart. Looking at those images, doctors can tell how much calcium has built up inside the arteries. Calcification is part of the plaque-building process, so the amount of calcium reflects the amount of plaque present. The more calcium (and plaque buildup), the higher the risk for heart attack or stroke.
"Diabetics or overweight individuals might have low cholesterol but be riddled with plaque," says Agatston. It depends, he explains, on the resistance of the vessel lining and the size of the cholesterol particles in the blood (smaller ones penetrate the vessel walls more easily). So regardless of what's considered high cholesterol or normal cholesterol, every person has a different breaking point where cholesterol will start clogging the pipes.
Who Needs a Heart Calcium Scan?
Family history of heart disease, being overweight, or having high blood pressure or diabetes might classify a person at intermediate risk for heart disease. Based on conventional risk factors, many people fall in the middle category.
"And most of those people, by doing the calcium score, can be reclassified correctly," Agatston says. Knowing a patient's calcium score can help a cardiologist prescribe the best plan of attack, be it statin therapy or a nutritionist, based on the likelihood of heart attack or stroke. Men after age 45 and postmenopausal women, often between age 50 and 55, would benefit most from the scan, says Agatston.
How Much Does a Heart Calcium Scan Cost?
New technology has dropped the price on coronary calcium scans. In Miami, where Agatston lives, they cost , but they might cost more in other parts of the country — up to 9. Some, but not all, insurance providers cover the preventative test.
Video: UCSF Radiology: Calcium Scoring vs. Coronary CTA Scan
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