Coronary Artery Calcium and your Calcium Score
While there is no doubt that high risk patients (those with multiple risk factors for heart disease, such as diabetes, family history or high cholesterol) need more aggressive preventive therapy, a majority of cardiovascular events occur in individuals with only 1-2 risk factors for heart disease. Coronary artery calcium (CAC) has been shown to be highly specific for atherosclerosis, demonstrating that if there is coronary calcium present, there is plaque building up in the coronary arteries. There is ample evidence to now show that elevated coronary calcium scores (CCS) are predictive of future cardiovascular events, both independently of and incrementally to conventional cardiovascular risk factors. Based on current available data, patients with increased plaque burdens (increased CCS) are approximately ten times more likely to suffer a cardiac event over the next 3-5 years. Coronary calcium scores have outperformed conventional risk factors, highly sensitive C-reactive protein (CRP) and carotid intima media thickness (IMT) as a predictor of cardiovascular events. Both Electron Beam Tomography (EBT) and multidetector computed tomography can accurately detect and quantify the CCS. In summary, coronary calcium detection significantly improves the accuracy of cardiac risk factors, the non-invasive tracking of the atherosclerotic burden and the prediction of future cardiovascular events. The newly issued SHAPE Guidelines call for all American Men over 45 years of age and all women over 55 years of age to undergo measurement of atherosclerosis, preferably with coronary calcium scanning to see if they are at risk of a heart attack or stroke.