- Calcium build-up in coronary arteries increases the risk of heart attack or stroke and can also increase the risk of diabetes, high blood pressure and elevated LDL cholesterol levels
- Patients with no calcium build-up have less than 3 percent chance of a cardiovascular event in the next 10 years.
- Recent study revealed that statins need not be given to individuals who have no calcium build-up in their blood vessels, regardless of whether other risk factors that lead to coronary disease are present or not.
Even though many individuals had well-known risk factors, it was found that they had less than three percent chance of a cardiovascular risk over the next decade. The American College of Cardiology and American Heart Association set a guideline that is way below the 7.5 percent level to begin statin treatment.
Dr. Parag Joshi, Cardiologist, Assistant Professor of Internal Medicine at UT Southwestern said: "The event rates when coronary calcium is absent are low."
‘A recent study indicates that statins need not be given to individuals who have no calcium build-up in their blood vessels, regardless of whether other risk factors are present or not’
The findings of this study reveal that statins need not be given to individuals who have no calcium build-up in their blood vessels, regardless of whether other risk factors that lead to coronary disease are present or not.
CT Scan Detects Heart Disease Risk
Statin therapy is good and there might still be many other reasons they could be used for. Doctors and patients are discussing treatment options and adding a CT scan for calcium can be worthwhile, says Dr. Joshi, a Fellow of the American College of Cardiology.
Dr. Joshi said that a CT scan gives a lot of information about the patient's risk in the next 10 years. It would cost about 100 bucks in the major cities and can be done easily. After the plaque builds up, calcium accumulates in the arteries of the heart and calcifies over time.
The UT Southwestern research team looked at CT scans of the chest and heart of patients who had never experienced a heart attack or stroke. About 6,184 people in the age group of 45 and 84 years participated in this large, multi-site, multi-year study, which is known as MESA (Multi-Ethnic Study of Atherosclerosis).
About half of the participants had a coronary artery calcium (CAC) score of zero. This indicates that there were no calcium deposits in their heart arteries.
Dr.Joshi said that a zero CAC score does not mean that there is no building up of plaque inside the arteries of the heart or that the patient is at zero risks. But rather means that the patient's risk for heart attack is lower than the threshold and if it is above the threshold, doctors recommend patients to be treated with statins.
A 5 percent risk is considered the low end for recommending statin use. Factors like age, sex, ethnicity, smoking, diabetes, high blood pressure, and cholesterol levels are used by the doctors for calculating the risk.
There may be controversies for starting statin treatment before any evidence of calcium build-up, as there might be chances that a patient could develop later in life due to family history and statins are inexpensive and carry little risk, reported Dr.Joshi.
Dr. Joshi is board certified in the use of coronary computed tomography angiography (CTA). CTA, a state-of-the-art technology provides a detailed view of the heart and related arteries.
"A CAC score can really add to the clinician-patient discussion over whether or not to start a statin for primary prevention of heart attacks and strokes," Dr. Joshi said.
The new findings of this study appear online in the Journal of the American College of Cardiology: Cardiovascular Imaging.
Coronary Artery Calcium Score
The presence of calcium in the coronary artery increases the risk of fatal and non-fatal coronary heart disease events by 5-fold in adults aged 32 - 46 years.
Coronary artery calcium (CAC) is a non-invasive measure of coronary artery disease that is associated with coronary heart disease (CHD) and cardiovascular disease (CVD) in middle and older age. It is usually measured by non-contrast cardiac computed tomographic (CT) scan.
Coronary calcium buildsup in the coronary arteries, so a CAC scan is essential in detecting minute amounts of CAC. Using a "CAC score," the scan results are recorded, which shows the total amount of CAC in the coronary arteries. The higher the CAC score, the greater the risk for heart disease in the future.
- Parag H. Joshi et al. The 10-Year Prognostic Value of Zero and Minimal CAC. Journal of the American College of Cardiology: Cardiovascular Imaging. (2017).DOI: 10.1016/j.jcmg.2017.04.016