The American Heart Association (AHA) and the American College of Cardiology (ACC) has endorsed coronary calcium scans as a screening tool for coronary heart disease. A recent study shows that calcium scans can help predict survival.
While the AHA and ACC advise against these computed tomography (CT) scans in people at low or high risk for a heart attack, the associations concluded that the scans can be valuable for people without symptoms of coronary heart disease (CHD) who are at moderate risk according to their Framingham risk score. The associations also concluded that a coronary calcium scan can be considered in people with chest pain who have unclear results on an exercise stress test.
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But as CT technology rapidly advances, CT scans of the heart are likely to have other important uses in the near future. Researchers are finding that these scans have the potential for quickly ruling out heart attacks in the emergency room and may one day offer sufficient detail to replace angiography for detecting blockages in the coronary arteries.
The expanded role of CT scans is supported by a study reported in the Journal of the American College of Cardiology (Volume 49, page 1860). The study indicates that CT scans that detect calcium in the coronary arteries, a sign of atherosclerosis, can help predict survival.
Researchers looked at more than 25,000 people without symptoms of coronary heart disease who had coronary calcium scans to assess their heart attack risk. Seven years later, 2% had died. After controlling for age, gender, and other heart risk factors, those with a calcium score of 11–100 (mild calcium buildup) had a twofold risk of dying of any cause, and those with a score greater than 1,000 (heavy calcium buildup) had a 13 times greater risk, compared with participants with a calcium score of 0. In addition, people with a score of 0 had a 10-year survival rate of 99%, compared with a survival rate of 88% for those with a score greater than 1,000.
Bottom line: Coronary calcium scans provide additional information about heart attack risk beyond such traditional risk factors as cholesterol, blood pressure, and smoking. This study suggests that calcium scans may do the same for predicting death. If you’re at moderate risk for a heart attack, your doctor may recommend a coronary calcium scan.
