A Noninvasive Way to Assess For Plaque in the Heart Vessels

One of the best non-invasive ways to take a closeevents; the St. Francis Heart Study. J Am Coll
look at the insides of the arteries supplying the heart isCardiology. 46, 158-165 (2005). A study such as this
via a heart scan. A heart scan allows us know thedisplays how important it is to correctly risk stratify
"coronary calcium score." A perfect score of course isoneself utilizing as many different modalities as
a "zero," which means there is no plaque in the heartpossible.
vessels. An Ultrafast CT heart scan, or Electron BeamAccording to MESA, the Multi-Ethnic Study of
Computed Tomography (EBCT) is a fast form ofAtherosclerosis, a novel coronary calcium score (CCS,
x-ray technology that is able to provide cross-sectionalor coronary coverage score) was studied. It described
images of the heart and its vessels. It is able tothe spatial distribution or the proportion of the coronary
quantify calcium plaque deposits in coronary arteriesartery affected by the plaque that is calcified and its
and therefore has proven itself to be an excellentrelation to cardiovascular risk. It has been proposed
diagnostic radiologic test for precise risk stratification ofthat CCS is a better predictor of cardiovascular risk
coronary artery disease. This test will enable you andthan the more traditional heart scans that measure
your physician to locate plaque in your coronaryoverall plaque burden. The Novel CCS, as well as the
arteries and decide on a treatment plan. This ability totraditional heart scan, were both predictors of coronary
find out one's "plaque burden" allows the physician andheart disease events, but the coronary coverage
patient alike to make a more informed decision aboutscore was a better predictor of future events. (Brown
medical intervention. An elevated plaque score mayER, Kronmal RA, Bluemke DA, et al. Coronary Calcium
prompt your internist or cardiologist to recommend aCoverage Score: determination, correlates, and
stress test, a more involved medication regimen, orpredictive accuracy in the multi-ethnic study of
even an angiography.atherosclerosis. Radiology. 2008;247: 669-678.)
Traditional blood tests would not be able to provideThe PREDICT trial (prospective Evaluationh of
such precise information. Many patients' risk profilesCoronary Artery Calcium in Predicting Cardiovascular
have changed after having assessed their coronaryEvents in Asymptomatic Patients with Type 2
calcium scores. A milestone study called the St FrancisDiabetes) presented at the 77th European
Heart Study showed that patients with elevatedAtherosclerosis Society Congress in Turkey, 4/08,
coronary calcium scores had a ten-fold increase inshowed that coronary artery calcification as measured
relative risk for any cardiovascular event compared toby EBCT ( electron beam computed tomography) is
those with no calcification burden. Taking this intoassociated with cardiovascular events in patients who
consideration, those patients with a risk for hearthave type 2 diabetes. It was found to be a stronger
disease initially quantified as intermediate, according torisk factor than traditional existing risk factors
the Framingham criteria, were converted into high orpresented in the Framingham study.
very high risk (Arad Y, Goodman KJ, Roth M, et al:Please talk to your internist or cardiologist about a
Coronary calcification, coronary risk factors, c-reactiveheart scan. Feel free to inquire at our office as well.
protein and atherosclerotic cardiovascular disease