Study questions broad use of coronary calcium scans for heart risk
A decade-long study of over 6,000 adults found that coronary artery calcium scans offer little added predictive value for many people when compared to standard risk calculators. However, for those with borderline or intermediate risk, the scans significantly clarified actual likelihood of developing heart disease. The findings suggest the test is most beneficial for a narrower patient group than previously thought.
The study drew on the Multi-Ethnic Study of Atherosclerosis, tracking over 6,000 adults aged 45 to 79 for a decade. Each participant received both a calcium score and a PREVENT risk estimate at the outset; 6 percent later had a heart attack or stroke. Calcium scores added little predictive power overall but meaningfully refined risk for those initially classified as borderline or intermediate.
The findings suggest a more selective role for the CT test. For low-risk patients, scans may bring radiation and costs without changing treatment. For high-risk patients, statins are already recommended regardless of calcium score, making the scan redundant. The research appeared in JAMA on August 26.
This research could reshape how clinicians order coronary calcium scans. If adopted broadly, fewer low-risk patients may undergo unnecessary CT imaging, reducing radiation exposure and healthcare costs. Patients in the borderline or intermediate category may benefit most, receiving clearer guidance on whether statin therapy is warranted. Insurers and health systems could also revisit coverage policies, potentially directing resources toward those most likely to gain from the test. However, individual patients with borderline risk may still want to discuss the scan with their doctors, as the test's value depends on personal circumstances.