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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Interpreting the Coronary Artery Calcium Score - Critical Information for the Practicing Physician
David S Schade1, Martin Hickey1, R Philip Eaton1
1University of New Mexico Health Sciences Center, Albuquerque.
Insights
Coronary artery calcium scanning assesses atherosclerosis risk. A higher calcium score indicates increased cardiovascular event risk, warranting aggressive treatment and lifestyle changes for better patient outcomes.
Area of Science:
- Cardiology
- Preventive Medicine
- Diagnostic Imaging
Background:
- Coronary artery calcium (CAC) scanning is a standard, cost-effective, noninvasive method for evaluating atherosclerosis severity in asymptomatic individuals.
- The test quantifies calcification in the four main coronary arteries, providing crucial data for risk assessment.
Purpose of the Study:
- To emphasize the importance of accurate interpretation of CAC scores for guiding physician recommendations and informing patients about their cardiovascular event risk.
- To highlight the correlation between CAC score, arterial calcium distribution, and the number of affected arteries in risk stratification.
Main Methods:
- Utilizes noninvasive imaging to quantify coronary artery calcium deposition.
- Interprets the calcium score considering age, sex, arterial location, and number of involved arteries.
Main Results:
- A CAC score of 0 suggests a very low risk of a cardiovascular event within 5 years.
- Any score above 0 indicates an increased risk, with higher scores correlating to greater risk.
- Individuals with scores >1000 have a one-third chance of a cardiovascular event within 3 years.
- Females generally exhibit lower CAC scores than males at any given age.
Conclusions:
- Elevated CAC scores necessitate aggressive management, including lifestyle modifications and lipid-lowering medications.
- Understanding CAC score interpretation is vital for enhancing therapeutic strategies and improving patient adherence to treatment plans.
Abstract:
Coronary artery calcium scanning is a routine test for assessing the severity of atherosclerosis in asymptomatic individuals. This inexpensive, noninvasive test quantifies the calcium deposition in the 4 principal coronary arteries. Correct interpretation is important to the physician (for recommending therapy) and to the patient (for determining his or her lifetime risk of a cardiovascular event). A score of 0 indicates that a cardiovascular event is extremely unlikely in the next 5 years. In contrast, a score greater than 0 portends a coronary event. The higher the score, the greater the risk. Both the arterial location of the calcium and the number of coronary arteries involved alter the interpretation of the calcium score. At any given age, females have significantly lower scores than males. One-third of individuals with scores greater than 1000 will have a cardiovascular event within 3 years. For all elevated calcium scores, aggressive treatment is warranted, including significant lifestyle changes and medications to reduce low-density lipoprotein cholesterol. Understanding the importance of the coronary artery calcium score will result in improved therapy and patient compliance.
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