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NEW YORK, Nov. 18 (UPI) -- Predicting who is at high risk for a heart attack or death may be as simple as obtaining a person's coronary artery calcium score -- a noninvasive way to measure plaque buildup, a new study indicates. The study is to be presented Monday at the American Heart Association National Scientific Sessions 2024 in Chicago.
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Coronary artery calcium scores are very effective in identifying both men and women at risk for heart attacks, as well as death from cardiac disease and all causes, researchers said.
However, before this study, it was unclear whether the prognostic value of these scores applied to women just as well as men.
"We're interested in finding a better marker of coronary risk," the study's principal investigator, Dr. Jeffrey Anderson, told UPI in explaining why he undertook this research.
Coronary artery calcium testing involves "a low-dose radiation scan of the heart that picks up calcified plaque," said Anderson, a distinguished clinical and research physician at Intermountain Health in Salt Lake City.
The test isn't consistently covered by insurance, but costs less than $100, he said, noting, "We think that it's a good investment for evaluating the risk of heart attack, which, of course, is an important thing to prevent."
A score of zero typically points to a very low five-year risk for coronary events. In this study, individuals with a score of zero were three times less likely to die from any cause, according to Anderson, a professor of cardiology, and his team.
The finding led the team to conclude that this tool offers an outstanding and precise measurement of health and overall prognosis -- for reasons beyond heart disease.
Coronary artery calcium testing is emerging as a more common method to assess risk of heart attacks. The noninvasive screening uses as little radiation as a mammogram and is relatively inexpensive, especially compared to PET stress tests, coronary CT angiograms or coronary angiography, researchers said.
They analyzed the electronic health records of 19,495 women and 20,523 men who had undergone PET/CT scans after their doctors suspected a risk of heart disease. The patients hadn't yet suffered a cardiac event, such as a heart attack.
Of these patients, 7,967 had a coronary artery calcium score of zero, which signified an absence of calcified plaque in their coronary arteries.
In this group, women on average were older than men (60.5 years versus 53.8 years). These averages correspond to how women often develop heart disease later in life than men, researchers said.
About two years later, researchers followed up on these patients. At that point, they found that a zero score predicted a low risk for coronary death or nonfatal heart attacks in both men and women. Such a score was more frequent in women despite an older average age.
Researchers said the capability of calcium artery score testing to predict all-cause mortality is novel and merits further investigation.
Other experts commended the investigators for demonstrating this test's prognostic value in both men and women.
"This study reaffirms that a low coronary calcium score correlates well with reduced fatal and non-fatal heart attacks," said Dr. Shukri David, chair of cardiology at Henry Ford Providence Hospitals in Southfield and Novi, Mich. He was not involved in the study
"This is particularly important information for females who are postmenopausal, since after menopause the cardiovascular risk in women for coronary blockages begins to equate that of their male counterparts," David said.
The well-conducted study's credibility lies in using data from a large number of patients. In addition, it's one of few studies where women are well-represented, with nearly 50% of participants being female, he said.
However, doctors can't assume these results apply to younger women, David said, adding that "we must continue to individualize patient's cardiovascular risk assessment."
Men age 45 or older and women age 50 or older should ask their doctor about obtaining a coronary artery calcium score, said Dr. Tamara Horwich, medical director of the Cardiac Rehabilitation Program at the David Geffen School of Medicine at UCLA in Los Angeles.
"Having a positive score would indicate the need for lifestyle and/or medication interventions to prevent future heart attack," Horwich said. "And the good news is that prevention is possible."
The test helps a doctor decide whether a patient should take a cholesterol-lowering drug, said Dr. Nisha Parikh, system director of the Women's Health Program at Northwell Health in New Hyde Park, N.Y.
Doctors often order this test in someone with heart disease risk factors, such as a family history and high cholesterol, high blood pressure, kidney dysfunction, diabetes and smoking status. In women, previous high blood pressure during pregnancy may be another reason to get the test, Parikh said.
