Heart Scan Overkill? New Study Questions Routine CAC Scans

A recent study published in JAMA suggests that coronary artery calcium (CAC) scans, a popular test for predicting heart disease events, may not be beneficial for a large portion of the population. Researchers found that the American Heart Association's PREVENT risk calculator often provides similar predictive accuracy using factors like age, blood pressure, cholesterol, diabetes, smoking, and kidney function.

The study followed over 6,000 individuals aged 45-79 for 10 years. While the PREVENT score alone was generally accurate, incorporating CAC scores did help reclassify about half of the individuals deemed at borderline or intermediate risk by PREVENT. This suggests CAC scans are most valuable for those in the middle-risk category when deciding on treatments like statins.

Experts note that CAC scans can refine treatment decisions, especially for those with intermediate risk where risk-enhancing factors not included in PREVENT might be at play. However, for individuals already clearly identified as high or low risk by PREVENT, a CAC scan may offer little additional actionable information, potentially leading to unnecessary radiation exposure and costs.

Recent cholesterol guidelines recommend using the PREVENT calculator for all patients aged 30-79. Discussing risk assessment with a doctor is crucial, and if deemed borderline, a CAC scan can provide further clarity. Regardless of risk level, adopting heart-healthy behaviors remains paramount for everyone's well-being.