February is American Heart Month. Did you know your heart beats more than 100,000 times each day and pumps about 1.5 gallons of blood each minute? This organ affects every part of the body and works hard to keep you alive, so it’s important to take good care of it and be aware of risk factors. Dr. Jason Galicia, Medical Director at Keystone Internal Medicine, explains coronary calcium scores and who should consider getting tested.
What is a coronary calcium score?
The coronary artery calcium (CAC) score is a screening test that measures the amount of calcified plaque you have in your coronary arteries. This is important because coronary plaque is the main underlying cause or precursor for atherosclerotic cardiovascular disease (ASCVD) events such as heart attacks and strokes.
Calcium in your bones and the food you eat is a good thing, but calcium in your arteries is not good at all. CAC scores measure coronary artery plaque, a waxy substance that is a mixture of fat and calcium. When left untreated, this substance can leave deposits in the artery, and the innermost layer of the artery may become calcified.
What test is used to measure CAC?
A CT scan is used, which is quick, easy and effective. These scanners use X-rays and do not require the use of contrast, IVs or special preparation by the patient. The radiation exposure is usually low — similar to a bilateral mammogram.
What does the score mean?
The calcium score you get from the test can range from zero to infinity and is connected with the risk of having a major cardiovascular event in the future, up to 15 years later. People who have no CAC have the lowest risk of heart events, while those who have high scores have been shown to have a higher risk of an event, even if they have no symptoms of heart disease. Here is a quick summary of what the scores mean.
Zero: No calcified plaque was detected, so your risk of a ASCVD event is lower. However, the risk is never zero, so being aware of your risk factors and lifestyle choices is still important.
1-10: You have some plaque, but only a small amount. Your risk for a heart event is still low, but you should talk with your healthcare provider about what you can do to keep your heart healthy.
11-100: You have a moderate chance of a cardiovascular event. You should talk with your doctor about treatment options and lifestyle changes.
101-400: The chance of you having a heart event is moderate to high. Your healthcare provider may recommend statin treatment to reduce cholesterol levels, in addition to healthy lifestyle habits.
Over 400: A large amount of plaque was found, and your chance of having an ASCVD event is high. Prescriptions like statins and PCSK9 inhibitors may be needed to reduce your risk.
Who needs this test?
According to the National Lipid Association, the test is recommended for individuals 40 years and above in the intermediate risk category who would like a more precise assessment of their risk to help guide treatment and medication decisions. Intermediate risk means you have at least one traditional cardiovascular risk factor, such as high blood pressure, high cholesterol, diabetes, obesity, or your doctor finds that you have an ASCVD risk score between 7.5% to 19.9% by using the American College of Cardiology/American Heart Association pooled cohorts risk calculator.
In addition, several recent guidelines from various scientific societies suggest that low-risk individuals with a strong family history of cardiovascular events or the genetic disorder called familial hypercholesterolemia, particularly involving events occurring at a young age, should consider getting the test for further risk assessment.
Speak with your healthcare provider about any concerns, including any family history of heart conditions. He or she will help you decide if a CAC test is needed.
What are some tips for keeping your heart healthy?
Always remember that a healthy lifestyle is the most important way to prevent cardiovascular events. Diet, exercise, getting to or maintaining a healthy weight and not smoking are still some of the best ways we can keep our hearts healthy.
This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.