Harvard Heart Letter

Heart scans hold intermediate promise

CT scans for calcium in the heart's arteries only benefit people in the gray zone of heart disease risk.

A debate over whether fast CT scanners should be used to go looking for "silent" heart disease still rages. These machines can detect calcium in the walls of coronary arteries, a sign of atherosclerotic plaque. Proponents claim that scans for coronary calcium save lives. Opponents argue that they do more harm than good by unnecessarily worrying people and leading to stent implantation or even bypass surgery without proven benefit.

Professional groups like the American Heart Association and American College of Cardiology were initially cool to the new technology. The latest guidelines from the two organizations, published in the journal Circulation, offer grudging acceptance for measuring coronary calcium. These guidelines come at an interesting time. A bill before the Texas legislature would widen the use of these machines even as the next generation of CT scanners threatens to make measuring coronary calcium obsolete.

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