Coronary Artery Calcium Scoring

Heart attack and stroke are some of Australia’s biggest killers. The Heart Foundation works to prevent people from developing heart disease through awareness campaigns, resources and support programs. 

Our guidance for health professionals includes the use of risk scores to help estimate a person’s risk of having a heart attack or stroke. As part of a Heart Health Check, your doctor can estimate your risk of heart attack or stroke based on any risk factors you may have. These can include raised blood pressure or high cholesterol. These factors are used to calculate a risk score, to estimate your risk of having a heart attack or stroke in the next five years. People can be classified as high, moderate, or low risk. Your doctor will make recommendations about changes to your health behaviours, such as stopping smoking. They may also prescribe medication to reduce the risk of a heart attack or stroke.  

The Heart Foundation reviewed the evidence to assess whether coronary artery calcium scoring can help better understand a person’s risk of having a heart attack. 

What is coronary artery calcium scoring?

A coronary artery calcium score is a measure of how much calcified plaque (calcium) is in the walls of your heart’s arteries (blood vessels). A build-up of plaque can cause these arteries to become narrow, reducing the amount of blood, oxygen and nutrients that reach your heart. In some cases, this plaque can break away and form a clot that blocks the arteries, causing a heart attack.

A coronary artery calcium score is measured using a non-invasive computed tomography (CT) scan of the heart. The CT scan shows how much calcium is in the walls of the heart’s blood vessels. The amount of calcium is reported on a number scale.  A score of zero indicates there is no calcified plaque. Medical dye or contrast is not used in CT scans for measuring a coronary artery calcium score. In someone without previous symptoms or a diagnosis, coronary artery calcium scoring can indicate a person’s risk of heart attack.

What is the Heart Foundation’s position on coronary artery calcium scoring?

Our position is that there can be a role for coronary artery calcium scoring in determining a person’s risk of heart attack. Our recommendations for the use of coronary artery calcium scoring are conditional. This means the recommendations are based on the best available evidence, but more research is needed to fully understand the role of coronary artery calcium scoring. The Heart Foundation acknowledges that Australian research on calcium scoring is limited. This affects the certainty of the evidence and our recommendations. We encourage people to speak to their doctor about their risk of heart attack and stroke. It is important to decide together whether a coronary artery calcium score is appropriate.

What do our recommendations mean for people?

The decision to have a coronary artery calcium score will depend on many factors. Your doctor will discuss these with you, including: 

•    Your risk factors 
•    Cost 
•    Your personal preferences and values 

How useful coronary artery calcium scoring is will vary from person to person. Your doctor is best placed to help work out if calcium scoring will be useful for you. Our recommendations guide health professionals on: 

•    When a coronary artery calcium score could be considered, and; 
•    How a coronary artery calcium score could be used to work out your risk of heart attack.