The Coronary Calcium Score Test (CCST) is a non-invasive imaging procedure used to assess an individual’s risk of developing coronary artery disease (CAD). This test uses specialized X-ray technology to look inside the arteries supplying blood to the heart. It detects early signs of plaque buildup before physical symptoms appear. The resulting score helps physicians understand the potential for future heart events, providing a clearer picture of cardiovascular health.
Essential Preparation: Addressing the Fasting Question
Fasting is generally not required for the Coronary Calcium Score Test (CCST). The test is a computed tomography (CT) scan that images physical calcium deposits, not a blood test measuring chemical levels. Food and drink intake typically does not interfere with the imaging technology’s ability to detect calcified plaque. Specific preparation is necessary, however, to ensure the highest quality images are captured.
You should avoid consuming caffeine, energy drinks, and nicotine for several hours before the exam, with four hours being a common instruction. These substances elevate your heart rate, causing the heart to move more during the scan, which makes it difficult for the CT scanner to produce clear images. Patients should continue taking all regular medications as prescribed, including heart-related drugs, unless a healthcare provider instructs otherwise. Always check with the testing facility for their precise preparation guidelines.
The Purpose of a Coronary Calcium Score Test
The Coronary Calcium Score Test quantifies the amount of calcified atherosclerotic plaque within the walls of the coronary arteries. This calcified material is a direct marker for atherosclerosis, which is the hardening and narrowing of the arteries. The presence of calcium indicates that plaque has been accumulating over time, signaling the early stages of coronary artery disease.
Measuring this calcium assesses an individual’s risk of experiencing a heart attack or other cardiac event in the future. The test is particularly useful for asymptomatic individuals who fall into an intermediate risk category based on traditional factors. By detecting plaque before symptoms develop, the CCST helps physicians move beyond general risk assessment to create a more personalized prevention strategy. A positive test confirms the presence of CAD. The score provides prognostic information that guides the decision to start or intensify preventive treatments, such as lifestyle changes or medication.
Understanding the Test Procedure
The test utilizes a specialized, high-speed CT scanner to capture images of the heart. The patient lies flat on a table that slides into the machine, which resembles a large, doughnut-shaped ring. Electrodes are placed on the chest to monitor the heart’s electrical activity, a process called electrocardiogram (ECG) gating.
This ECG synchronization allows the scanner to take images only when the heart is between beats, minimizing motion blur and ensuring clear pictures. The entire procedure is quick, often lasting less than 10 minutes, with the actual scan taking only a few seconds. Patients are asked to hold their breath briefly, typically for 10 to 20 seconds, while the images are recorded. The CT scan involves a small dose of radiation exposure, which is considered very low.
Interpreting Your Calcium Score
The results of the test are expressed as a single numerical value known as the Agatston score. This score is calculated based on the number, size, and density of the calcified plaques detected in the coronary arteries. A higher score corresponds to a greater amount of calcified plaque and a higher risk of a future heart event.
The most desirable result is a score of zero, which indicates no detectable calcified plaque and a very low risk of coronary artery disease. Scores are categorized by risk level:
- 1–100: Suggests a mild presence of plaque, with low to moderate risk.
- 101–400: Considered moderate, indicating a higher risk of heart attack within the next few years.
- Over 400: Signifies extensive plaque, placing the individual in a high-risk category that prompts aggressive preventative measures.