Coronary artery calcium build-up, often abbreviated CAC, is the build-up of calcium in the coronary arteries. Measured using a non-invasive CT scan, CAC is a marker of heart disease and can help predict risk of heart attack. However, CAC is not often taken into account when calculating a patient’s risk for developing heart disease. Instead, 10-year risk for heart disease is typically assessed using risk factors like age, cholesterol, blood pressure and smoking status.
In a study recently published in the Journal of the American College of Cardiology, researchers analyzed data from the Multi-Ethnic Study of Atherosclerosis, which investigates risk factors related to heart disease. The study includes a diverse group of more than 6,000 U.S. men and women who were free of heart disease and followed for ten years.
At the start of the study, participants underwent CT scans to assess calcium build-up and provided information about their health and lifestyle. For ten years, researchers then surveyed participants periodically about their health and tracked key outcomes like heart attack and death.
After analyzing results, researchers found that calculations taking into account traditional risk factors plus CAC better predicted 10-year risk of heart disease than traditional factors alone. View the risk calculator used in this study.
As authors explain, their new calculations are the first to incorporate traditional cardiovascular risk factors with CAC scores when estimating cardiovascular risk. Although additional research is needed to validate this tool, researchers hope their findings will help better identify patients at risk for heart disease.
Risk prediction tools are frequently used to assess a patient’s risk for developing heart disease and to identify patients that could benefit from preventive therapies. Thus, improved risk calculations could more accurately assess a patient’s risk for heart disease and guide treatments like lifestyle changes and cholesterol-lowering medications. One important caveat: Since CAC is not yet recommended as a routine part of screening or risk assessment, insurance currently doesn't cover the cost of CAC scoring.