Coronary Artery Disease

[Rose117]

Does a score of 308 on a cardiac calcium scoring test indicate coronary artery disease?

[Rose117]

Thank you for your informtion.  Needless to say, I was not given this type of information.  I was merely told, based on the cardiac calcium score, that I had coronary artery disease and am scheduled for a CTA exam.  From your information, I believe that the CT is a risk indicator and that the CTA should show if there are any blockages.  You have given me much more information than my doctor's nurse, who is the one who spoke to me.  I wish medical personnel would realize that some of us out here need all the information we can get before we make decisions about further testing.

Thanks again.

[e.r.boy]

The cath angiogram is actually not the gold standard anymore. It can only tell you if you have blockages. IVUS : intra vascular ultrasound will be the gold standard going forward. An angiogram cannot tell you how diseased your arteries are until they are really, really bad. Check out PBS.org and search for 'The hidden epidemic" Its a very interesting documentary.

[kenkeith]

A calcium score can help RISK stratify you for major cardiac events over the long term, but it DOES not tell you specifics about the extent of your current blockages.  A CT angiogram or a cath angiogram can do that--cath is still the gold standard.

Recommendations for asymptomatic individuals based on their coronary calcium sore can be summarized as follows.  Calcium scores of 0 identify individuals in the "lowest-risk" group with 10 year risk for cardiac events less than 5%.  These individuals are to be reassured and CAC scans should be repeated no more often than every 5 years.

Calcium scores between 1 and 80 also identify "low-risk" individuals.  Consequently; these individuals can be recommended to undergo risk factor modification alone and the CAC scans may be repeated at two to five year intervals to monitor for progression.

Calcium scores from 81 to 400 identify individuals at increased risk for cardiac events and many of these individuals will be re-stratified to the "intermediate-risk" or "high-risk groups".  

Although the extent and specifics of occlusions, the "high-risk" group and these individuals have a high likelihood (>90%) of having at least one significantly obstructed coronary vessel (>70% stenosis). The risk for  the development of symptomatic cardiac disease in these patients may be as high as 4.8% per year and additional evaluation for the presence of at risk myocardium should be done in addition following the secondary heart disease prevention guidelines of the American Heart Association.  Repeat CAC scans are recommended annually to monitor disease progression and treatment response.