1. What is a Coronary Calcium Screening (CCS)?
· The actual screening is a Computed Tomography Angiography (CTA) Scan which is a non-invasive, painless heart imaging test. The scan produces high resolution 3-D pictures to identify either fatty or calcium deposits (plaque) inside the arterial walls. The test itself usually takes 5-10 minutes to complete.
2. What is fatty or calcium deposits (plaque)?
· In medical terminology, deposits of calcium and fatty material in the arteries is called atherosclerosis. This buildup of calcium deposits increases the risk of cardiovascular disease. People with elevated levels of calcium in their blood are much more likely to have heart attacks and strokes.
Per the American Heart Association (AHA) plaque itself can pose a risk. A piece of plaque can break off and be carried by the bloodstream until it gets stuck. This plaque can narrow an artery which can cause the possibility of a blood clot (thrombus) sticking to the arterial wall. If either is the case, the artery can be blocked, cutting off blood flow.
If the block artery supplies the heart or brain, a heart attack or stroke occurs. If an artery supplying oxygen to the extremities (often the legs) is blocked, gangrene or tissue death can occur.
3. What is cardiovascular disease (CVD)?
· Cardiovascular disease can refer to a number of conditions. But these are the most common:
o Heart Disease
o Heart Attack
o Heart Failure
o Heart Valve Problems
4. Why should I be concerned about CVD?
· Per the American Heart Association (AHA) heart disease is the number one killer worldwide. Stroke ranks number two globally. Even when these conditions don’t result in death, they cause disability, diminishes the quality of life and produces immense health and economic burdens.
· Per the World Health Organization (WHO) in 2016, 17.9 million people died from Cardiovascular disease (CVD). This accounts for 31% of all registered premature deaths. Of these deaths, 85% resulted from a heart attack or stroke. This is true even in places where infectious diseases are rampant. Cardiovascular disease affects men and women equally.
5. Why should I consider getting a CCS?
· According to Johns Hopkins researchers, data from almost 7,000 subjects compared two approaches to calculating heart risk. One way used only the traditional risk factors, like smoking, cholesterol, blood pressure and diabetes.
The other included coronary calcium scoring. Results reported in 2013 in the European Heart Journal showed that by looking at the coronary calcium score, doctors could much better estimate heart disease risk, especially for those thought to be at low risk or high risk.
Fifteen percent (15%) of those thought to be at very low risk using traditional risk factors actually had high coronary calcium scores. Thirty-five (35%) of those thought to be high risk showed no coronary artery calcium and therefore a lower risk of cardiovascular events.
Even those who are classified as low risk may benefit from CCS to see where they stand and to make improvements in their risk factors and make modifications to their risk behaviors.
6. What does the results of a CCS tell me?
· The findings from the CTA help doctors determine a patient’s 10-year risk for heart disease, stroke, heart attack, and/or cardiovascular disease. This prediction or score is made based on the amount of plaque found inside the arterial walls and is called the Agatston Score.
7. What is an Agatston Score and how is it related to CCS?
· The results from the CTA is expressed in terms of a score. This score is called The Agatston Score. The score reflects the total area of calcium deposits and the density of the calcium. When calcium is present, the higher the score the higher your risk of cardiovascular disease. Following is a breakdown of the scores:
o 0- No plaque present. Less than 5% chance of cardiovascular event in 10 years.
o 1-10- Small amount of plaque present. Less than 10% chance of cardiovascular event in 10 years.
o 11-100- Plaque is present. Mild cardiovascular disease. 10%-12% chance of a cardiovascular event in 10 years.
o 101-400-Moderate amount of plaque present. Plaque may be blocking an artery. 13%-16% chance of a cardiovascular event in 10 years.
o 400+- Large amount of plaque present. More than a 90% chance that plaque is blocking at least one artery. 22%-29% chance of a cardiovascular event in 10 years.
o 1,000+-Very large amount of plaque present. >90% chance of artery blockage. Very high risk; 25 % chance of a cardiovascular event within A YEAR!
8. Who should get a CCS?
· CCS is appropriate for those with one or more of the following risk factors:
o Men 40+
o Women 50+
o Family History of Cardiovascular Disease
o High Cholesterol
o Overweight or Obese
o Sedentary Lifestyle
o Physician recommendation
9. What treatment can I expect my doctor to recommend after I receive my CCS results?
· Depending on your results, your doctor could discuss or recommend one or more of the following treatment strategies:
o No change to current treatment
o Different medication or doses of medication
o Changes to your diet and exercise routine
o New/Increased weight-loss goals
o Additional tests
o Referrals to specialists
o Follow-up appointments to monitor your health and treatment plan.
10. How often should I have a CCS?
· A repeat CCS can be useful if your condition needs to be monitored. If you have a very high calcium score it is unlikely to change, but low and moderate scores can be worth repeating to see if it has changed. Another scan could be recommended in 2-5 years as well as some lifestyle changes to protect your arteries.