Heart disease is the world’s leading cause of mortality, comprising 32% of all deaths.
But that doesn’t mean people are powerless against the condition — there are some steps they can take to help reduce the risk.
In addition to adopting healthier lifestyle habits, getting a specific screening — the coronary artery calcium (CAC) score — can help detect early signs of heart disease, experts say.
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What is the CAC score?
The CAC score is a specialized CT scan that measures calcium buildup in the walls of the heart’s arteries, according to board-certified cardiologist Dr. Robert Segal, founder of Manhattan Cardiology and co-founder of https://www.labfinder.com.
“This calcium points to the accumulation of plaque that can cause heart disease,” he told Fox News Digital.
The higher the score, the more calcium in the arteries, thus a greater likelihood of a heart attack, stroke or other cardiac issue.
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A calcium score of zero indicates no coronary calcium and places the individual at a very low risk for heart disease. A calcium score greater than 400 indicates a high risk of heart disease, according to Dr. Bradley Serwer, an interventional cardiologist and chief medical officer at VitalSolution, an Ingenovis Health company that offers cardiovascular and anesthesiology services to hospitals.
“The CAC score is obtained with a rapid, low-dose CT scan,” Maryland-based Serwer told Fox News Digital.
“A high score indicates that you should work with your doctor to reduce your risk.”
The scan images are processed using specialized computer software, producing what is called an “Agatston score.”
“This computer algorithm evaluates how much calcium is present and calculates a number or score,” Serwer said.
The CAC score is a “non-traditional risk factor” that isn’t as widely known as more routine screenings like cholesterol checks or blood pressure measurements, according to Segal.
“Still, awareness is rising as more research shows how valuable it is in forecasting cardiac disease,” he said.
What to do with the CAC score
The result of the scan can help people take charge of their cardiac conditions, experts say.
“It’s helpful because it helps identify heart disease early, even if you have no symptoms,” Segal said. “This allows for preventive steps, like lifestyle changes or medications, to lower your risk.”
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If the CAC score is zero, Segal recommends keeping up good practices and continuing to track risk variables.
“A low score indicates mild plaque; therefore, lifestyle changes such as improving diet, exercising and lowering cholesterol will help,” he said. “A high score indicates that you should work with your doctor to reduce your risk, maybe with statins.”
Generally, if a CAC score is zero, there is little need to repeat the study for five years, according to Serwer.
For those with an elevated calcium score, there is limited data on the benefit of repeat testing.
“These patients should discuss their individual case with a trained cardiologist to determine the need for any further testing,” Serwer advised.
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The test is used in combination with other risk factors, such as cholesterol, blood pressure and diabetes, to determine who needs aggressive medical therapy for primary prevention of heart disease.
“The earlier we can identify those at higher risk of a heart attack, the earlier we can start them on proven therapies to avoid bad outcomes,” Serwer said.
“While we have no data that shows merely performing this test makes you live longer, knowing who we need to treat aggressively and knowing when we can delay or avoid medical therapy is very important.”
Potential risks and limitations
In terms of potential risk, Segal compared the CAC scan to a mammography, noting that it’s fast, noninvasive, uses only a small amount of radiation, and does not involve dye injection.
“It only gauges current calcium, and it cannot identify soft plaque that’s not solidified,” he noted.
Segal also cautioned that a zero CAC score does not imply zero risk — particularly in cases of diabetes or smoking, which are additional risk factors.
“It’s a useful instrument to be coupled with other health evaluations,” he added.
How to get the test
People interested in getting the CAC score should start by seeing a cardiologist.
“Those between the ages of 40 and 70 who have risk factors like high cholesterol, high blood pressure or a family history of heart disease are usually advised to get the scan,” Segal said.
Serwer recommends that patients discuss individual risk with their primary care provider to determine whether the test will be helpful.
“We don’t currently have standardized guidelines for testing or frequency of repeat testing,” he said.
“Some plans consider this test elective or investigational and therefore won’t pay for it.”
The test can be performed in most radiology departments. For those who are only getting a coronary artery calcium score, there is no preparation required, Serwer noted.
“There is no need for IV contrast, so there is no need to fast or obtain blood work prior to getting this study.”
Coverage for the CAC test varies based on individual insurance plans.
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“Some plans consider this test elective or investigational and therefore won’t pay for it,” Serwer noted.
“Medicare currently does not cover the cost for asymptomatic people for risk stratification purposes.”
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