Heath Effects of Calcium Build-up in Arteries is More Complex than Previously Thought
The size and density of coronary artery calcium have contrasting effects on risk for heart disease.
The dangers of calcium build-up in the heart’s arteries may be more complex than initially realized, based on a recent study that explored the impact of coronary artery calcium on future heart risk.
Published in JACC: Imaging, this study looked at the impact of both volume and density of coronary artery calcium on heart health. Coronary artery calcium is the build-up of calcium in the heart’s arteries, which significantly increases risk for heart disease and heart events. Based on current standards, the larger and more dense the calcification is, the greater its threat to heart health. However, recent studies suggest that dense coronary artery calcium may be less dangerous than plaque with less density.
To learn more, researchers analyzed data from the MESA study (Multi-Ethnic Study of Atherosclerosis), which has tracked the heart health of nearly 7,000 U.S. adults since the early 2000s. Participants were 66 years old on average and free of heart disease at the start of the study.
While all patients were seemingly healthy upon enrollment, imaging showed that 3,398 adults had significant calcium build-up in their arteries. During 11 years of follow-up, 390 of these adults developed heart disease or suffered heart attack or stroke.
After analysis, researchers found that larger coronary artery calcium was associated with significantly greater risk for heart disease. However, each standard increase in calcium density decreased cardiovascular risk by 25–28%. Researchers also found that incorporating both calcium volume and density into current risk scores significantly improved their accuracy for predicting heart events.
What this means, according to authors, is that current methods used to evaluate coronary artery calcium may be outdated. The Agatston score, which was first developed in 1991, is typically used to predict cardiovascular risk based on coronary artery calcium. It assumes greater volume and density both increase future risk for heart disease. As this study confirms, dense calcification actually helps protect against heart events.
As a next step, experts hope to develop and evaluate new methods for predicting heart risk based on coronary artery calcium. The association between coronary artery calcium and heart risk is complex, as findings show. Experts hope that more detailed assessments will better identify patients at risk for heart disease and help patients lower their cardiovascular risk.
Questions for You to Consider
- What is coronary artery calcification?
- Coronary artery calcification (CAC) is the buildup of calcium in the arteries, which can cause blood vessels to narrow and lead to the development of heart disease.