Coronary artery calcium scores. Should I get one?

A coronary calcium score is a low-resolution CT scan of your heart which identifies calcium in your coronary arteries. Coronary artery calcium (CAC) is the product of atheroscloerotic, cholesterol plaque that has been in your coronaries for greater than 5-10 years.  The presence of CAC suggests that you are at increased risk of a heart attack and/or stroke and helps inform discussions with your doctor about further diagnostic testing and cholesterol-lowering treatment.

However, coronary artery calcium scores (CCS) aren’t for everyone.  Calcium scores are only helpful in people who do not have known coronary disease and have no symptoms of cardiac chest pain.  People with low pre-test probability of having CAC – i.e. young, healthy people without other risk factors for coronary artery disease – do not need a calcium score.  Similarly those who are high risk for coronary artery disease should be on cholesterol lowering medications anyway regardless of their CAC score.

Currently, the American College of Cardiology and American Heart Association guidelines state that CAC scores can be considered to further risk stratify and inform treatment decisions in patients meeting the following criteria:

• Age 40-79 years old
• No signs or symptoms of coronary artery disease
• No diabetes
• LDL cholesterol < 190 mg/dl
• ASCVD (i.e. atherscloresitc cardiovascular disease) risk score of >/= 7.5% to <20%

You can calculate your ASCVD risk score here: http://tools.acc.org/ASCVD-Risk-Estimator-Plus/#!/calculate/estimate/

The chart below details what the results of the coronary calcium score mean. You and your doctor will use your calcium score along with your other risk factors for coronary artery disease to determine if further diagnostic testing is needed and/or if you should start a statin.

Learn more about calcium scores here: https://www.mayoclinic.org/tests-procedures/heart-scan/about/pac-20384686