Calcium Score: a coronary calcium test for cardiovascular risk prevention

By Cristiano Antonino On Dec 30, 2022

Calcium Score: prevention through coronary calcium assessment plays a key role in the treatment of heart disease

Ischaemic heart disease (myocardial infarction) is the leading cause of death in Western countries; the quantification of coronary calcium (Calcium Score) can provide valuable information on the health status of the coronary arteries.

Coronary atherosclerotic disease is manifested by the formation of plaques in the vessels (the coronary arteries) that supply the heart with oxygen and nutrients.

Calcium can accumulate within the atheromasic plaques and can be identified using the Calcium Score method

Dozens of scientific studies have shown that the presence of coronary calcium correlates directly with an increased likelihood of myocardial infarction.

In particular, higher coronary calcium levels are associated with an increased risk of ischaemic heart disease.

Compared to the evaluation of traditional cardiovascular risk factors, such as hypertension and hypercholesterolaemia, the quantification of Coronary Calcium represents a powerful marker that offers the advantage of a direct and early diagnosis of atherosclerotic damage in the coronary arteries, which in turn precedes actual ischaemic heart disease.

Identifying patients at increased risk of developing myocardial ischaemia (cardiac infarction) is a real challenge, and the early diagnosis of coronary artery disease, through the use of the Calcium Score, makes effective preventive intervention possible before myocardial infarction occurs.

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Coronary Calcium Quantification (Calcium Score): what is it?

Calcium Score is a non-invasive imaging method that involves the use of CT (computed axial tomography) and has the advantage of being performed without the use of contrast medium.

The CT scan, using special cardiology software, is able to accurately quantify the coronary calcium content that tends to accumulate in atherosclerotic plaques within arterial vessels.

The Calcium Score is expressed by a number that correlates directly with the probability of incurring adverse cardiovascular events (e.g. myocardial infarction); a higher number corresponds to a higher cardiovascular risk.

As with all methods that use X-rays (e.g. X-rays, CT scans, coronarography), this method also requires the use of potentially harmful radiation. However, thanks to the continuous development of ever more perfected protocols and technological advances, the amount of radiation to which one is exposed has been significantly reduced and is significantly lower than that of a traditional CT scan of the chest, making this method easy to perform and accessible to the general population.

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Calcium Score, who should perform the Coronary Calcium Assessment?

The most recent International Guidelines for Cardiovascular Prevention identify certain precise groups of people who may benefit from Coronary Calcium Score quantification.

In particular, subjects with intermediate cardiovascular risk and diabetic subjects are those in whom precise coronary calcium quantification may be most useful.

The identification of coronary calcium, in fact, especially if the calcium level exceeds a certain threshold, makes it necessary to implement aggressive cardiovascular prevention, such as starting high-dose statin therapy, optimising blood pressure values, strict glycaemic control, all with the aim of reducing the risk of cardiovascular events.

On the other hand, the absence of coronary calcium (Calcium Score = 0) makes the probability of incurring ischaemic cardiovascular events extremely rare in the next 5/10 years.

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