Harvard Heart Letter

Heart beat: Calcium scan benefit still uncertain

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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