Introduction
Cardiovascular disease is the major cause of death around the globe, and coronary artery disease (CAD) accounts for half of all these deaths. Approximately 25 percent of patients have acute myocardial infarction or sudden death with no prior symptoms. Identifying asymptomatic individuals at a higher risk of developing future cardiovascular events is of utmost importance for implementing preventive strategies.
What Is Coronary Artery Calcium Score?
The coronary artery calcium score is used to indicate a significant relationship between the medium or long-term occurrence of major cardiovascular events. Total risk scores are highly useful and must be utilized as the initial method of classification. These are able to predict only 65 to 80 percent of future cardiovascular events. The characterization of coronary-artery calcification through computed tomography can be used in equivalence with the risk of cardiovascular events and total coronary atherosclerosis load.
Why Is a Coronary Artery Calcium Score Test Performed?
A calcium scoring test is used by healthcare providers to provide efficient treatment decisions for individuals experiencing borderline risk of heart disease. Calcium score testing results are usually helpful for patients between ages 40 and 70 and at increased risk for heart disease without any symptoms.
The following people are at an increased risk of cardiovascular disease:
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Individuals with a family history of heart disease.
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People with a history of diabetes, high cholesterol, or high blood pressure.
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Overweight individuals with a body mass index (BMI) higher than 25.
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People with an inactive lifestyle.
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People who use tobacco products.
How Often Must a Calcium Score Test Be Performed?
Patients might benefit from calcium score tests that are performed every three to five years, according to research. It is essential to repeat a scan if a normal score is achieved for the first time and if one wants to know if the risk is still low. However, repeating the test if one has already obtained unusual findings is not useful.
How Is a Calcium Score Test Done?
A calcium score test is performed with the help of a CT (computed tomography) machine to scan the heart. The scan is used to identify areas in the coronary arteries that have calcification. The CT scan usually takes a few minutes; however, the entire procedure might take about 10 or 15 minutes. It is a non-invasive procedure.
Before undergoing the calcium score test:
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Inform the healthcare provider about the allergies, medications being taken, and whether the patient is pregnant.
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Avoid drink, food, caffeine, and tobacco products for four hours prior to the performance of the calcium score test.
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The patient must remove any metal on the body, including jewelry and glasses, and change into a hospital gown.
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The patients have to lie on their backs on a special table which is slid into the middle of a scanner.
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A provider places small, sticky electrode patches on specific chest areas. The electrodes are attached to an electrocardiogram (EKG) monitor that records the heart’s electrical activity during the test and helps the providers to record pictures of the heartbeat.
What Are the Risks Associated With a Calcium Score Test?
A calcium score test does not involve any contrast dye injection, so it has no side effects. There is a minor cancer risk, especially if several CT scans are performed, and the patient is younger than 40.
A calcium score test exposes the patient to the same amount of radiation as an individual would naturally get over a year. A CT scan can be harmful to the fetus, so doctors do not recommend this scan for pregnant women.
Other risk factors include:
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Family history.
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Lifestyle habits like smoking, consuming an unhealthy diet, and physical inactivity.
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Medical conditions like high blood pressure and diabetes.
What Type of Results Are Recorded and What Do the Results Mean?
A positive test indicates that the scan shows evidence of calcium in the coronary arteries suggesting that the patient has coronary artery disease. The calcium test score shows how much calcium is present in the coronary arteries. If there is calcium in the heart’s arteries, the computer creates a calcium score that measures the extent of coronary artery disease. Calcium test scores can range from zero to more than 1,000.
Any score above zero indicates that there is some evidence of coronary artery disease (CAD).
A high score indicates that a person is at risk for a heart attack. Score cutoffs are:
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One hundred or less: Mild indication of coronary artery disease.
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Up to 400: Moderate amount of coronary artery disease.
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Above 400: Strong evidence of coronary artery disease.
What Is the Normal Calcium Score?
The normal calcium test score is zero. Healthcare providers consider it as a negative scan because there is no calcification seen in the heart’s arteries. With this score, there is a very low risk of a heart attack in the next two to five years. In certain hospitals, the results are given on the same day. A radiologist usually the results of the calcium scoring test and shares them with the doctor.
What Should be Done if the Results Are Abnormal?
If the scan results are abnormal, the doctor might refer the patient to a cardiologist (heart specialist). After considering the calcium scoring test, the doctor might decide on the following:
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Administration of a statin to manage the cholesterol level.
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Regular exercise.
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Alterations in the diet.
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Perform more tests.
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Regular follow-up to monitor the condition.
Conclusion
The coronary artery calcium score independently measures the risk for cardiac diseases and cardiac mortality. Further, it gives prognostic information on other cardiovascular risk markers The indications for the use of the coronary artery calcium score include classification of global cardiovascular risk for asymptomatic patients. In symptomatic patients, the pre-test probability must always be considered in interpreting the coronary artery calcium score as a tool to indicate the best method for diagnosis. In diabetic patients, the coronary artery calcium score helps in the identification of the individuals who are at the most risk and can benefit from testing for silent ischemia and for more aggressive clinical conditions.
