Heart disease remains one of the leading causes of death worldwide. Traditionally, many patients begin treatment only after experiencing a cardiovascular event. However, experts at the University of Alabama at Birmingham and UAB St. Vincent’s want patients to be aware of a screening tool that offers a proactive approach called a coronary calcium score that works by assessing an individual’s risk of developing heart disease before symptoms appear.
What is a coronary calcium score?
“A calcium score is a fast, noninvasive, quantitative measure of coronary plaque,” said Jacob Townsend, M.D., interventional cardiologist at UAB St. Vincent’s. “It is the most important noninvasive testing for asymptomatic patients.”
A calcium score is measured with a CT scan of the heart, without contrast, and uses very little radiation. It provides a numerical score the represents the amount of calcification found in the coronary arteries.
“The calcium score on its own is helpful in risk-stratifying someone with no plaque versus those on the other end of the spectrum with very high plaque volume; but we are also able to provide a snapshot of where you as an individual are compared with others of the same age, race or gender,” Townsend said.
While most people will develop calcification, or plaque, in their arteries as they age, an individual’s calcium score is helpful in determining whether a patient is showing trends of developing plaque faster than others of a similar profile.
“Recognizing the presence of plaque allows your doctor to tailor their recommendations and encourage aggressive risk factor control or even further testing, such as a nuclear stress test or heart catheter, if warranted,” Townsend said.
Who should get a calcium score screening?
“A calcium screening is ideal for asymptomatic patients who want to better understand their cardiac risk,” Townsend said.
Additionally, doctors recommend a calcium score for those who have a strong family history of cardiovascular diseases and/or an elevated cholesterol panel and those with traditional risk factors such as tobacco use, diabetes, high blood pressure and obesity.
“A calcium score is an important component of preventive cardiology and is too often underutilized,” said Christopher DeGroat, M.D., interventional cardiologist at UAB St. Vincent’s. “This tool helps us predict a patient’s future risk of cardiovascular disease, which helps us make the best decisions about their heart health management before an issue occurs.”
Understanding your calcium score
There are two factors that doctors consider when assessing a calcium score: the score itself as well as how it compares to others within the same demographic.
DeGroat explains that zero is ideal, while less than 100 is mild, 100-400 is moderate, and more than 400 is severe.
“Outside of the score itself, a calcium score that is less than the 50th percentile for age would suggest that a patient is developing plaque at a slower rate than the general population, and that’s a good thing,” Townsend said.
When a patient has an elevated calcium score but is otherwise asymptomatic, both DeGroat and Townsend first recommend patients be put on a daily aspirin regimen and cholesterol management, along with improvements to diet, sleep and exercise.
“When I’m able to know a patient’s calcium score history, I do have a lower threshold for proceeding with aggressive testing if symptoms do arise,” DeGroat said.
Final thoughts
While an elevated calcium score does suggest an increased risk of future cardiac events such as myocardial infarction, stroke and peripheral arterial disease, it does not mean a patient currently has obstructive coronary artery disease.
“I always look at the patient as a whole. Coronary calcium score is one tool that gives us a better picture of how best to treat a patient,” DeGroat said. “When a patient is more aware of the state of their heart health before a cardiac event happens, they can be more in tune when mild symptoms start to present and not delay seeking treatment.”
Townsend adds that a calcium score screening helps take the guesswork out of where a patient’s heart health stands.
“Instead of guessing at whether one has coronary disease based on the presence or absence of traditional risk factors, this test allows someone to know precisely whether they have disease and to what extent,” Townsend said.
The cardiologists and care teams at UAB St. Vincent’s are experts in prevention and early detection who can help you improve your heart health with a treatment plan that is right for you. Learn more about UAB St. Vincent’s cardiology or schedule an appointment with a cardiologist today.