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Harvard Heart Letter | July 2008
Heart beat
Calcium scan benefit still uncertain
Using
a special CT scan to measure calcium deposits in the arteries that
nourish the heart has been promoted as a way to predict the chances of
having a heart attack. In theory, this makes sense. Since calcium is
part of the buildup of cholesterol-filled plaque in artery walls,
measuring it might be one way to foresee the heart’s future. But
concerns that this approach might not work for people of all
ethnicities and doubts about its cost-effectiveness have dogged the
test.
The results of a four-year study of 6,700 white,
black, Hispanic, and Chinese volunteers put the ethnicity concern to
rest. In each group, people with higher calcium scores were more likely
to have had a heart attack or to have died from heart disease compared
with those with low scores (New England Journal of Medicine,
March 27, 2008). The results don’t answer the question of how much
extra information the $500 test adds to the free and easily calculated
Framingham risk score. Health insurers don’t routinely cover the cost
of coronary calcium scanning.
The results shouldn’t change
current recommendations about CT calcium scanning. If your heart
disease risk is low or high, don’t bother having this test. It may, and
we stress the may, offer reassurance or directions for therapy
if your risk is somewhere in between. Equally important, don’t wait for
a CT scan result — or the onset of heart trouble — to exercise, eat
right, watch your weight, and stop smoking. These are things that
everyone, even those at low risk, should do.
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