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Do you know your Heart KYC (Know your Calcium) Score of Coronary Arteries?

Understanding Calcium Score of the Coronary Arteries

What is Calcium (Ca) Score?
It is a test that measures the amount of coronary artery calcium (CAC).

So, what is coronary artery calcium?
This is the calcium (Ca) that is deposited within the abnormal plaques caused by damage to the lining of the arteries.

Arteries-small
The color image shows the actual coronary arteries and the branches.

What is coronary artery disease (CAD)  and what happens when there is CAD?
Due to a variety of reasons, when there is damage to the lining of the arteries, there is deposition of abnormal soft or hard material (plaque) within or in the wall of the artery.
This eventually leads to blockage, either acute, which can cause immediate death or a bad “heart attack” or chronic, leading to chest pain (angina).

Calcified plaque with narrowing (arrow)
Calcified plaque with narrowing (arrow)

How does the Ca score test help?

  • By measuring the amount of Ca in the coronary arteries, the Ca score tests can assess the risk of CAD/heart disease.
  • When the test picks up calcified (hard) plaques (the tip of the iceberg), it implies that there are also non-calcified soft plaques in the coronary arteries, which are the ones that are more likely to rupture and cause sudden catastrophic events.
  • A positive Ca score test implies that there is CAD that needs attention.

How is the test done?
The test is done in a CT scanner in less than a minute.
The entire procedure from filling the form to getting the result usually takes less than
10 minutes.

No preparation required.
No fasting required.
No radiation risk.
No injection of dye.

How good is the test compared to other tests like blood cholesterol levels, ECG, echo, stress tests?
Ca score test is the single best risk predictor for coronary artery disease currently available.

What does the Ca score test reveal?
Ca score of 0 means that the chance of CAD is almost nil.
The higher the Ca score, the more is the chance of a cardiac problem in the next 5-10 years.

What happens if we have a positive/high Ca score?
Depending on the amount of Ca score, measures have to be taken to reduce risk and to stabilize the plaques in the coronary arteries with a combination of sensible eating, exercise and medications like statins and aspirin.

Management Recommendation (based on the Expert Consensus Statement of the Society of Cardiovascular Computed Tomography 2016)**

ScoreRiskTreatment Recommendation
0very lowstatin not recommended
1-99mildly increasedModerate intensity statin if <75%

Moderate to high-intensity statin if >75%

100-299moderately increasedmoderate to high intensity statin + ASA* 81 mg
>300moderate to severely increasedHigh-intensity statin + ASA 81 mg

*ASA – acetylsalicylic acid – aspirin
**This is a general recommendation that should be discussed with your physician in detail before starting medication
Lifestyle modification with diet and exercise is a must to complement the medication

How often should the test be repeated?
Once in 3 years, if positive and once in 5 years if the score is 0.