Heart Calcium Scans Help Borderline-Risk Patients Most — SkimNews
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- Northwestern Medicine researchers followed 6,000+ adults for 10 years and found that adding a coronary artery calcium score to the AHA's PREVENT calculator raised discrimination only from 0.73 to 0.75 for the overall population.
- For borderline- and intermediate-risk patients — those initially estimated at a 3% to 9% ten-year risk of cardiovascular disease — the calcium scan produced a more meaningful improvement in predicting who would actually suffer a heart attack or stroke.
- Dr. Nilay Shah, the study's senior author and a Northwestern cardiology professor, cautioned that routine scanning in low-risk patients 'may result in unnecessary radiation exposure, testing and costs with unclear clinical benefits,' while high-risk patients are already recommended for statins regardless of scan results.
- The study, published Aug. 26 in JAMA, drew on data from the Multi-Ethnic Study of Atherosclerosis; 6% of participants experienced a heart attack or stroke during follow-up.
- The researchers flagged that more work is needed in South Asian and Filipino adults and in people younger than 45, since enrollees were ages 45 to 79 at the start of the study.
- The findings also implicitly validate the relatively new PREVENT calculator, which predicted cardiovascular risk well on its own without the additional imaging.
Why it matters: Roughly 10% of U.S. adults age 30-79 already have cardiovascular disease, and the new analysis argues that calcium scans should be reserved for patients sitting in the 3-9% ten-year risk gray zone, not ordered routinely. Shah said this narrower use case would spare low-risk patients from unnecessary radiation and costs while still helping doctors decide who truly needs a statin.
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