Calcium scoring is a non-invasive imaging test that helps assess heart health. This procedure utilizes computed tomography (CT) to detect calcium deposits within the coronary arteries. The primary objective is to identify early signs of coronary artery disease, a condition where arteries become narrowed or blocked.
What Calcium Scoring Detects
Calcium scoring, also referred to as a coronary artery calcium (CAC) scan, employs CT imaging to identify and measure calcified plaque within the arteries supplying blood to the heart. These calcified plaques indicate atherosclerosis, a process where arteries harden and narrow over time. The scan reveals the presence and extent of these calcium deposits.
The presence of calcified plaque signifies a history of atherosclerosis, even without symptoms. This hardened plaque is distinct from soft, non-calcified plaque, but its presence signals underlying disease. By quantifying these calcium deposits, the scan provides a measure of the atherosclerotic burden in the coronary arteries.
How Calcium Scoring Predicts Future Risk
The presence and quantity of calcium in the coronary arteries correlate with the likelihood of future cardiovascular events, such as heart attacks and strokes. A higher calcium score indicates greater atherosclerosis, suggesting an elevated long-term risk of these events. This test serves as an independent predictor of risk, often providing more precise insights than traditional risk factors alone.
Calcium scoring helps reclassify individuals from intermediate to higher risk categories. For instance, a study found that people with a CAC score of 400 or higher had a significantly elevated risk of major adverse cardiovascular events (6.8%), compared to 1.9% for those with scores between 1 and 399. This reclassification can guide healthcare providers in recommending more aggressive preventive strategies, such as cholesterol-lowering medications or lifestyle adjustments.
Interpreting Your Calcium Score and Its Nuances
Calcium scores are reported as a numerical value, ranging from zero to over 1,000. Higher numbers indicate increased calcium and a greater extent of coronary artery disease. A score of zero suggests a very low risk of a heart attack within the next two to five years. Scores between 1 and 100 indicate mild calcification, while scores from 101 to 400 suggest moderate calcification. Scores above 400 point to severe calcification and a higher risk of a heart attack.
While a high score indicates increased risk, a score of zero does not guarantee immunity from future cardiovascular events. The scan primarily detects calcified plaque and does not identify soft, non-calcified plaque, which can also lead to acute events if it ruptures. Interpretation is influenced by individual factors, including age, biological sex, and existing risk factors like high cholesterol, high blood pressure, and diabetes. For example, women often have lower scores than men at any given age, even with similar risk profiles.
The calcium score represents one piece of a broader health assessment. It provides valuable information that, combined with other clinical data and patient history, helps healthcare providers tailor preventive measures. Discussion with a healthcare provider is necessary to understand the score’s implications and determine appropriate next steps for risk management.