A coronary calcium score (or sometimes known as Agatston score) utilises a specialised type of x-ray called a CT scan. It measures how much calcified plaque is in your coronary arteries.
Coronary artery disease (CAD) is caused by a build-up of fatty (atherosclerotic) plaque in your coronary arteries. This plaque can harden and become calcium. By analysing the amount of calcium along your coronary arteries, your cardiologist will be able to determine the presence of CAD or the risk of developing CAD.
Your likelihood of having heart disease or a heart attack correlates with your calcium score. The lower your calcium score and percentile rank, the less likely you are to have a cardiac event compared to other men or women your age.
A coronary calcium score is recommended for those with risk factors such as:
- Age (above 40 years old for males & above 50 years old for females)
- Personal or family history of cardiovascular diseases
- High cholesterol
- High blood pressure
- Diabetes
- Smoking (both present or past)
- Obesity
The calcium score is age-adjusted. The higher the calcium score, the higher the risk of developing a heart attack.
- Zero: No plaque. Your risk of heart attack is low.
- 1 – 10: Small amount of plaque. You have less than a 10 percent chance of having heart disease, and your risk of heart attack is low.
- 11-99: Some plaque. You have mild heart disease and a moderate chance of heart attack. Your cardiologist may recommend other treatment in addition to lifestyle changes.
- 100 – 399: Moderate amount of plaque. You have heart disease and plaque may be blocking an artery. Your chance of having a heart attack is moderate to high. Your cardiologist may want more tests and may start treatment.
- 400 and over: Large amount of plaque. You have more than a 90 percent chance that plaque is blocking one of your arteries. Your chance of heart attack is high. Your cardiologist will perform more tests and will start treatment.
The calcium score is very accurate in detecting coronary calcium plaques. The CT scanner can take multiple images of the heart in thin sections, which allow the machine to calculate the calcium score based on the amount of calcification.
Do note that your calcium score only detects plaque that contains calcium, and in some people, they may have plaques which do not contain any calcium. These are fatty plaques made up of fat and cholesterol deposits which may not be detected with calcium score alone. Moreover, more calcium will be detected in the coronary arteries with increasing age, and this may lead to a higher calcium score detected in older persons.
Your cardiologist will determine which tests are most suitable for you, and utilise the information obtained from calcium score to give you an accurate risk assessment of coronary artery disease.
The scan involves a small amount of radiation. Do share your concerns with your cardiologist, and do inform if you are pregnant, suffer from any medical conditions, taking medications or have any known allergies.
Your cardiologist will discuss your results with you during a follow-up appointment. Based on your results, they will decide if other tests are needed and whether you need to take preventive measures to lower your risk of a heart attack.
If you have an elevated calcium score, you can reduce your risk of developing a heart attack. Medications such as statins lower bad LDL cholesterol and reduce inflammation in the blood vessel walls. Heart-healthy lifestyle changes such as eating healthily and getting regular physical exercises are essential in lowering your risk.
Cardiovascular disease is the leading cause of death in the world. The calcium score is a helpful tool to detect calcified plaque in the coronary arteries. The amount of calcified plaque together with other risk factors will indicate your risk of a future heart attack. Work with your cardiologist to lower your risk of coronary artery disease through preventive measures, regular follow-up and following a heart-healthy lifestyle.
