Before you delve into their findings, here's what you need to know about
coronary arteries and coronary calcium scores (also called Agatston
The coronary arteries supply oxygen-rich blood to heart muscle. In coronary
artery disease, plaque builds up inside coronary arteries' walls, narrowing the
arteries. Calcium is one of the components of plaque. The more plaque that is
present, the more calcium is present in the walls of heart arteries. So
measuring coronary calcium can be used as a surrogate for measuring plaque.
Coronary calcium measurements are derived from computed tomography (CT)
scans of the heart and are quantified into "scores." Coronary calcium
scores aren't new. But previous research has shown that whites have higher
coronary calcium scores than minorities. That's where the new study comes
Coronary Calcium Scores
The researchers asked whether coronary calcium scores predicted heart
"events" -- heart
attack, death from coronary heart disease, or chest
pain (angina) -- in whites, African-Americans, Chinese, and Hispanic
The study included more than 6,700 U.S. adults with no history of heart
When the study started, participants were 45-84 years old; on average, they
were in their 60s. They got CT heart scans and were told whether their coronary
calcium score was negative, low, average, or greater than average. They were
also advised to talk to their doctor about their test results.
Participants were followed for up to five years. During that time, 17 people
died of coronary heart disease, 72 had a nonfatal heart attack, and 73 had
As in other studies, whites tended to have higher coronary calcium scores.
But in all ethnic groups, people with higher coronary calcium scores were more
likely to have heart "events" during the study.
For instance, someone with a coronary calcium score of 101-300 was more than
seven times as likely to experience a heart "event" than someone with
no evidence of coronary calcium.
There are other well-known risk factors for heart disease, including smoking, obesity, poor cholesterol profiles, and family history of heart
disease. Coronary calcium scores add more information on the patients' risk,
note the University of California at Irvine's Robert Detrano, MD, PhD, and
Because relatively few people in their study had heart "events,"
follow-up studies are needed. Detrano's team also notes that some people may
have been inspired to upgrade their heart's health when they got their coronary
calcium scores at the study's start.
"Is this relatively small improvement in accuracy worth it? Does calcium
scoring provide value? Here the issue is uncertain," states an editorial
published with the study.
Coronary calcium scoring "remains an interesting technique" and
studies of its cost-effectiveness should be done, write the editorialists, who
included William Weintraub, MD, of the Christiana Care Health System in Newark,