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You just got back your cholesterol lab results. Your doctor wants to put you on a statin to lower your “bad “cholesterol. You’ve heard so many bad things about statins and wish there was another way to determine your actual heart attack risk. Now there is another tool that can help guide your heart health decisions.
Heart disease remains the leading cause of death in the US with a heart attack (myocardial infarction) happening every 40 seconds. Nearly one-fifth of US adults have an intermediate risk of Atherosclerotic Heart Disease (ASHD) events (heart attack or stroke). Intermediate-risk patients are often hesitant to start statin therapy when they are symptom-free.
A simple non-invasive Coronary Artery Calcium (CAC) CT scan can be done to look for calcification in the heart's arteries. In the past, primary care doctors had to decide if statin therapy was a good option with little actual evidence to back up their recommendation. Now a simple, quick, non-invasive (CAC) CT scan can give your doctor a way to measure your risk of having a cardiovascular event such as heart attack or stroke.
According to Mayo Clinic, a buildup of fats, calcium, and other substances in the heart vessels is called plaque. This plaque builds up slowly over the years long before there are any symptoms of heart disease. A (CAC) CT scan may be done to detect early coronary artery disease which is a common heart condition. You might have this CT done if:
You have a strong family history of early heart disease
Your risk for heart attacks is intermediate, not high or low
Your level of heart attack risk is uncertain
The CT results may help you and your doctor understand your risk and help determine what treatment plan might be best for your heart health.
A coronary artery calcium CT scan is not recommended if you are at high risk for heart attack, had a heart attack, stent, or bypass surgery. Other tests will be used for those conditions that show the heart arteries.
Because you do receive low-dose radiation with this scan, it isn’t for everyone. How does your doctor determine if you should have a (CAC) CT? Some of the factors your provider may consider include:
Your age
Your blood pressure
Your cholesterol level
Whether you smoke
Your gender
The heart scan is most helpful for those at medium risk which means you are probably between the ages of 40-70 with some risk factors but no symptoms.
In 1990, preventive cardiologist Dr. Arthur Agatston, author of The South Beach Diet, published the scoring system used today to score the results of the (CAC) CT scan. Dr. Agatston from Miami, Florida practices cardiology at https://www.theagatstoncenter.com/.
The Agatston scale used today is as follows:
0 = no identifiable calcium particles
1-10 = Low risk. Less than 10% chance of heart disease
11-99 = MILD calcium deposits
100-399 = MODERATE calcium deposits
400-999 = SEVERE calcium deposits
1000+ = 25% chance of heart attack within a year
According to the American Heart Association, the (CAC) CT scan costs between $100-$400. Because this CT scan is relatively new and not included in standard screening for heart disease, most insurance companies do not cover the cost. It may be covered if your provider orders it to help diagnose a problem. Some states like Texas now require insurance to cover the scan when recommended by the care provider.
The option of a (CAC) CT scan gives you and your provider another tool to determine appropriate heart health care for you. If you are at intermediate risk and are undecided about statin, or aspirin therapy, this CT scan may give you clarity. The cost may vary greatly depending on your location. Making phone calls to local health centers and your insurance company will likely pay off. Knowledge is power, and knowing your heart artery status can give you confidence when you collaborate with your provider to receive the best possible heart health care.
Sources:
Assessed and Endorsed by the MedReport Medical Review Board