The Heart Foundation has today released recommendations for doctors on the use of coronary artery calcium scoring to support the prevention of heart attack and stroke but calls for more research to define its role in Australia.
A coronary artery calcium score, or calcium score, is a measure of how much calcium is in the walls of the heart's arteries. Calcium, along with fat, cholesterol, and other substances found in the blood, creates plaque. The build-up of plaque over time can block an artery, causing a heart attack or stroke.
The recommendations, published today in the Medical Journal of Australia, give doctors practical advice on deciding when and how to use calcium scoring to help identify a person's risk of having a heart attack.
Heart Foundation Chief Medical Adviser and cardiologist, Professor Garry Jennings, said that in some people without previous heart attack or stroke, calcium scoring could be considered to help reclassify a person's risk following a Heart Health Check.
"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 risk factors are used to estimate your risk of having a heart attack or stroke in the next five years," Professor Jennings said.
"After a Heart Health Check, you will know whether you have a high, moderate, or low risk of having a heart attack or stroke.
"If you are found to be at moderate risk, calcium scoring may help guide your doctor on how intensely to manage your risk factors."
But Professor Jennings said coronary artery calcium scoring will not be appropriate for everyone, because in some groups of people, it won't change how a person is treated or managed.
"Those groups include people who are already known to be at high risk of a heart attack or stroke or people who have already had one."
Calcium scoring is measured using a CT scan of the heart to see how much calcium is visible in the walls of the arteries. A score of zero indicates there is no calcified plaque.
Currently, coronary artery calcium scoring is not covered by Medicare, so the cost of the test is an out-of-pocket expense, and that cost varies across the country.
"The decision to use calcium scoring will depend on many factors. Your doctor will discuss these with you to decide whether calcium scoring is right for you."
Professor Jennings said that despite the new recommendations being based on the best available evidence, more research is needed to understand how coronary artery calcium scoring is directly relevant to Australians.
"This will help define the role of calcium scoring in the prevention and management of heart attack in Australia.
"Our current advice is for people to see their GP for a Heart Health Check. Following your results, talk with your doctor about whether calcium scoring is suitable for you."
People 45 years or over, or 30 years and over for Aboriginal and Torres Strait Islander peoples, can visit their GP for a Heart Health Check. The check is subsidised by Medicare and calculates a person's risk of heart attack or stroke in the next five years.
