Health
Coronary calcium scans offer most value as tiebreakers for borderline cardiovascular risk, studies find
New research shows adding calcium scoring to the PREVENT risk calculator provides limited benefit overall but helps guide statin decisions for patients with uncertain risk.
The short version
- Two recent studies of over 6,000 individuals found that coronary artery calcium (CAC) scans only modestly improve general heart attack and stroke risk predictions when added to the PREVENT calculator.
- CAC scans offer significant value for patients classified at borderline or intermediate risk by reclassifying who needs cholesterol-lowering statins or other preventive treatments.
- Experts emphasize that a CAC score of zero should not automatically rule out statins, as some patients with zero calcium still experienced cardiovascular events.
- Patients facing out-of-pocket costs between $100 and $400 for CAC scans must weigh whether the additional imaging will meaningfully alter their treatment plan.
Key facts
- Two new studies analyzing data from more than 6,000 participants aged 45 to 79 in the Multi-Ethnic Study of Atherosclerosis evaluated CAC scores alongside the PREVENT calculator over 10 years.[STAT]
- Adding CAC scores to PREVENT risk models provides a modest overall prediction improvement of 1% to 2% for people screened for cardiovascular disease, but substantially aids reclassification for borderline and intermediate risk groups.[STAT]
- CAC scans are generally not covered by insurance and typically cost patients between $100 and $400 out of pocket.[STAT]
- Updated ACC-AHA guidelines recommend using incidental calcium findings for statin decisions in men aged 40 and older and women aged 45 and older who fall into borderline or intermediate risk categories.[STAT]
- Research indicates CT scans performed for unrelated medical reasons perform similarly to specialized CAC scans in predicting 10-year cardiovascular outcomes.[STAT]
What remains uncertain
- It remains uncertain how widely doctors will adopt CAC scans solely to resolve treatment decisions given the potential out-of-pocket costs for patients.[STAT]