Heart disease often develops quietly, without obvious symptoms in the early stages, which is why prevention and risk assessment are so important. Risk is not determined by a single number. Age, family history, blood pressure, cholesterol, diabetes, smoking history, and overall health can all play a role. In some cases, a coronary artery calcium scan can provide additional insight by helping detect calcified plaque in the arteries of the heart, giving doctors and patients more information when making decisions about prevention and treatment.
Often called a CAC scan, this non-contrast CT scan measures calcium in the coronary arteries. The higher the calcium score, the more plaque is likely present and the greater the long-term risk of future cardiovascular events. Recent cholesterol guidelines also recognize CAC as a useful tool when the decision about starting a statin is still uncertain.
Who May Benefit From CAC Testing?
This does not mean everyone needs the test. In general, CAC scanning is most useful for people who are not clearly low risk or high risk based on the usual factors such as cholesterol levels, blood pressure, diabetes, smoking history, and age. According to current ACC guidance, it may be especially helpful for men age 40 and older and women age 45 and older with borderline or intermediate 10-year cardiovascular risk if the result would help determine whether statin therapy should be started.
For some patients, the result can make the next step clearer. A score of zero may suggest a lower near-term risk in the right clinical setting, while a higher score may support more aggressive LDL lowering and a stronger prevention plan. At the same time, a calcium score is only one part of the picture. It does not replace a full cardiovascular evaluation, and a score of zero does not mean a person has no risk at all. Blood pressure, family history, symptoms, diabetes, smoking history, weight, and other factors still matter.
There are also situations where the test may be less helpful. If someone already has known coronary artery disease, has had a heart attack or stroke, or has already undergone procedures such as stenting or bypass surgery, the presence of disease is already established, so CAC scanning is generally not the main question. The test is best understood as a risk-assessment tool for selected patients, not a routine screening test for everyone.
An Individualized Approach at Dedication Health
At Dedication Health, our concierge cardiologists take an individualized approach to prevention and treatment. That means looking at the full picture rather than relying on a single number alone. For some patients, a coronary calcium scan may be a helpful next step when the best course of action is not yet clear. For others, the better recommendation may be medication, lifestyle changes, ongoing monitoring, or a different type of evaluation based on symptoms, history, and overall risk.
If you have risk factors for heart disease or questions about whether a statin is right for you, it is worth having a conversation with your cardiologist or primary care physician about whether coronary calcium testing would be useful in your specific case. The right answer depends on your personal risk profile, not just one lab value.
Which communities does Dedication Health serve?
Dedication Health is accepting new patients in Wilmette, Winnetka, Kenilworth, Glencoe, Highland Park, Chicago, Evanston, Skokie, Arlington Heights, Northbrook, and surrounding North Shore communities.
For additional reading on this topic, you can view the Wall Street Journal article here: Read the full article on WSJ. The article discusses how calcium scoring is being used to help assess heart disease risk and guide cholesterol treatment decisions.