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CT Scan Predicts Heart Attack, Death

Reviewed by Gary D. Vogin, MD
From the WebMD Archives

Jan. 23, 2002 -- A new study shows that an ultra-fast CT scan can help predict your chance of dying from a heart attack or sudden heart death. What does this mean for you?

Also known as electron-beam CT, or EBCT, the $400 test measures the amount of calcium build-up in the heart arteries, giving you a "calcium score." This score is an indication of artery blockage, but doctors don't agree on how well it foretells the future.

Many have touted the test as an easy, non-invasive, and accurate way to look for heart disease. But others have said that the scan can't tell you anything more than other common methods for predicting heart disease, such as cholesterol and blood pressure measurement.

In this latest study, researchers from Tulane University School of Medicine in New Orleans tested 98 people, average age 62, with very high calcium scores (1,000 or higher -- an indication of potentially significant blockage) but no symptoms of heart disease.

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After having an ultra-fast CT heart scan, the study participants were followed for up to 36 months. None of them had further heart tests based on the findings of their CT.

During the study, 36% of the people either had a heart attack or died from sudden heart death. Higher calcium scores did indeed predict with some accuracy who would suffer this fate. Those with a score of about 1,500 were much more likely to suffer a heart attack or heart death than were those with a score of around 1,200.

The findings are featured in the Jan. 16 issue of the Journal of the American College of Cardiology.

The researchers then compared these study participants to a group of people from an earlier investigation in whom a well-established heart test had identified severe heart blockage. The people with high calcium scores fared worse than the people from the previous study. This indicates that a high calcium score is at least somewhat effective at predicting future severe heart problems.

People with high calcium scores need aggressive treatment for heart disease, according to senior researcher Paolo Raggi, MD, and colleagues.

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If you're willing to pay for the ultra-fast CT heart scan -- and insurance is unlikely to cover the cost -- many places offer the test. But even if money is not an issue -- you may be concerned about what the test will tell you. That's exactly what worries many doctors.

This study, and others like it, allows us -- at least to a certain degree -- a glimpse into our own future. You don't need your doctor's OK to have the test done, but if your calcium score comes back high, you will certainly need to discuss the results, and your next step, with your doctor. Will it mean you'll go on to have additional tests? Will your doctor start treating you for heart disease?

At this point, these questions haven't been answered. And that's why some doctors aren't comfortable with the test. Discuss the ultra-fast CT scan with your doctor and see what he or she thinks. Then the two of you can come up with a plan to determine your heart disease risk.

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An interesting question comes up from time to time when discussing calcium and heart disease. Since calcium in the heart is found in blocked arteries, does this mean that the calcium supplements you take for osteoporosis can cause heart disease?

The answer is "no." Calcium supplements will not increase the risk of developing heart disease -- it may actually decrease that risk. The calcium in blocked arteries results from inflammation. Calcium in the diet or from supplements does not affect this process.

In fact, a study from the University of South Carolina in Columbia showed that a higher intake of calcium may decrease the chance of dying from heart disease -- at least for women after menopause. They also found that calcium from the diet, supplements, or both, could protect the heart. So your heart should rest easy when it comes to taking calcium to protect your bones.

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