“My utmost priority is to provide the highest quality and most up-to-date cardiovascular care to all my patients. I aim to achieve this using a holistic approach in a personable and empathetic atmosphere, while taking into consideration each individual patient’s own wishes and hopes for their medical care.”
Patient groups to consider Coronary Calcium Scoring
- CAC is of most value in intermediate risk patients aged 45-75 years, who are asymptomatic and who do not have known coronary artery disease. In such patients it may have the ability to reclassify patients into lower or higher risk groups.
- It may also be considered for lower risk patients, e.g. for those with a family history of premature CVD and possibly in patients with diabetes aged 40 to 60 years of age.
Patient groups in whom Coronary Calcium Scoring should not be considered
CAC is not recommended for patients who are:
- Very low risk
- High risk – as testing is unlikely to alter the recommended management
- Symptomatic or previously documented coronary artery disease.
Interpretation of CAC
CAC = 0. A zero score confers a very low risk of death, <1% at 10 years.
CAC = 1-100. Low risk, <10%
CAC = 101-400. Intermediate risk, 10-20%
CAC = 101-400 & >75th centile. Moderately high risk, 15-20%
CAC > 400. High risk, >20%
Management recommendations based on CAC
Optimal diet and lifestyle measures are encouraged in all risk groups and form the basis of primary prevention strategies. Patients with moderately-high or high risk based on CAC score are recommended to receive preventative medical therapy such as aspirin and statins. Generally aspirin and statins are recommended if the CAC is >100.
Repeat CAC testing
In patients with a CAC of 0, a repeat CAC may be considered in 5 years but not sooner.
In patients with positive calcium score, routine re-scanning is not currently recommended. However, an annual increase in CAC of >15% or annual increase of CAC >100 units are predictive of future heart attacks and death.