Coronary artery calcium (CAC) scoring is a non-invasive tool used to assess heart disease risk. It helps healthcare providers understand the extent of calcified plaque in the coronary arteries, which indicates atherosclerosis. For a 70-year-old woman, this assessment offers valuable insights into cardiovascular risks, guiding preventive efforts.
Understanding Coronary Artery Calcium Scoring
A calcium score measures the amount of calcified plaque in the walls of the coronary arteries, which supply blood to the heart muscle. This calcified plaque is a hallmark of atherosclerosis, a condition where fatty deposits build up and harden in the arteries. It indicates coronary artery disease (CAD) and can help predict future cardiovascular events like heart attacks or strokes.
The test involves a non-invasive computed tomography (CT) scan of the heart, typically without contrast dye. The CT scanner identifies and quantifies calcium deposits, which are then used to calculate a score, most commonly the Agatston score. This score numerically represents the calcified plaque burden, with higher scores indicating more atherosclerosis.
Interpreting Calcium Scores for Older Adults
The Agatston score, ranging from 0 to over 400, is used to interpret coronary artery calcium. A score of 0 indicates no detectable calcified plaque, suggesting a very low risk of coronary artery disease. For a 70-year-old woman, while a score of 0 is ideal, some calcium is commonly found with increasing age; over 67% of women over 70 may have some coronary artery calcification.
A score between 1 and 99 indicates mild calcification, suggesting a low to moderate risk of coronary artery disease. Even low scores above 0 warrant attention, particularly in older individuals, as they still signify the presence of atherosclerosis. Scores ranging from 100 to 399 suggest moderate calcification and a moderate to high risk of heart attack within three to five years.
A score exceeding 400 signifies extensive calcification and a high risk of coronary artery disease. Patients with scores above 400 may have a risk of major cardiovascular events similar to those with established cardiovascular disease. Comparing an individual’s score to others in their age group can provide a more accurate risk assessment.
Implications and Next Steps After a Calcium Score
Receiving a calcium score is a significant step, but it represents only one piece of a broader cardiovascular risk assessment. The score should always be interpreted by a healthcare provider in conjunction with other individual risk factors. These factors include blood pressure, cholesterol levels, family history of heart disease, and lifestyle habits.
Based on the calcium score and overall risk profile, a healthcare provider will outline potential next steps. For individuals with a score of 0, there may be no immediate need for daily aspirin or statin medication, though healthy lifestyle choices remain encouraged. If the score is above 100, recommendations often include routine low-dose aspirin and statin medication.
Lifestyle modifications, such as adopting a healthy diet, increasing physical activity, and quitting smoking, are universally recommended to reduce cardiovascular risk regardless of the score. In some cases, particularly with higher scores (e.g., over 400), further diagnostic testing like a stress test or coronary CT angiogram might be recommended to assess blood flow and identify potential blockages. It is important to discuss the results thoroughly with a healthcare provider to develop a personalized plan to manage and reduce future cardiovascular risk.