In recent years, coronary artery calcium (CAC) testing has gained popularity as a tool for assessing cardiovascular risk. This imaging test, also known as a calcium score test or heart scan, measures the amount of calcium in the walls of coronary arteries. A higher CAC score suggests a greater burden of atherosclerotic plaque and, subsequently, a higher risk of heart disease. As with many new diagnostic tools, CAC testing has some big advantages. This article explores the key benefits of CAC testing, offering an evidence-based overview for those considering this test.
CAC testing is a specialized type of CT (computed tomography) scan that detects calcium deposits in coronary arteries, which supply blood to the heart. The test produces a “calcium score,” a numerical value that indicates the amount of calcium in these arteries. The score generally ranges from 0 (no calcium detected, indicating very low risk) to several hundred or more (suggesting a higher risk of coronary artery disease).
One of the main benefits of CAC testing is that it’s non-invasive. Unlike traditional angiography, which involves inserting a catheter into the arteries, CAC testing requires only a simple CT scan. It’s generally painless and takes less than 10 minutes to complete, with results available shortly afterward.
CAC testing helps to stratify cardiovascular risk in individuals who may not have significant symptoms but are still at risk of heart disease. Studies have shown that individuals with a high CAC score are at a significantly higher risk for cardiovascular events, such as heart attack, compared to those with a low or zero score. According to the American Heart Association, CAC testing can be especially helpful for individuals in the intermediate-risk category who are uncertain about starting statin therapy or other preventive measures.
CAC testing can guide a more personalized approach to cardiovascular care. For instance, a high CAC score may prompt a cardiologist to prescribe medications like statins or aspirin, while a low or zero score could suggest a more conservative approach. This customization can potentially lead to better outcomes and minimize the risk of overtreatment or undertreatment in patients.
One of the surprising benefits of CAC testing is its impact on patient motivation. The visibility of calcified plaques in coronary arteries often has a strong psychological impact on patients, encouraging them to adopt healthier lifestyle habits. A high CAC score can be a “wake-up call,” motivating patients to improve their diet, exercise routine, and smoking cessation efforts. This behavioral change can have long-term benefits for overall cardiovascular health.
Traditional risk factors, such as age, blood pressure, cholesterol levels, and family history, are widely used to assess cardiovascular risk. However, CAC testing can reveal additional risk not captured by these factors. For example, a person with normal cholesterol levels but a high CAC score may still have significant atherosclerosis and benefit from early intervention. In this way, CAC testing complements traditional risk assessments, providing a more comprehensive picture of cardiovascular health.
For individuals at intermediate risk of cardiovascular disease (usually those with a 10-20% 10-year risk based on traditional risk assessment models), CAC testing can provide valuable additional information. It is also considered useful for patients with risk factors that don't clearly point to high or low risk. For example, someone with a strong family history of heart disease but few traditional risk factors might gain valuable insight from a CAC test.
The U.S. Preventive Services Task Force (USPSTF) currently has no specific recommendation on CAC testing, but organizations like the American Heart Association and the American College of Cardiology recognize its value in certain cases. Generally, CAC testing should be discussed with a healthcare provider to determine its potential benefits based on individual health history and risk profile.
Coronary artery calcium testing is a valuable tool for assessing cardiovascular risk, especially for individuals in the intermediate-risk category. Its benefits include effective risk stratification, support for personalized treatment plans, and increased motivation for lifestyle changes. As with any medical decision, discussing CAC testing with a healthcare provider is essential to ensure that it aligns with one’s health goals and risk factors.
