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Low Coronary Artery Calcium Score Associated With An Excellent Prognosis Regardless Of A Person's Age, New Study Finds
Having a coronary artery calcium (CAC) score of zero has generally been accepted as a marker of a very low risk of having a cardiac event within the next five years. However, age is a strong contributor to coronary risk, with risk increasing markedly as people age.
Whether age-related risk factors diminish the low risk predicted by a zero coronary artery calcium score has been uncertain – until now.
A large new study of more than 40,000 patients from heart researchers at Intermountain Health in Salt Lake City finds that a zero coronary artery calcium score continues to be an accurate indicator of a low risk for a coronary heart event even as a person ages.
Moreover, researchers found that patients with a zero coronary artery calcium score also had a two to three times lower risk of death from any cause at any age, including in seniors.
The findings of the new study are important because as cholesterol-laden plaques in the heart's coronary arteries age, they attract calcium.
"We found that a zero-plaque burden is not only highly prognostic of good heart health at any age, but also of excellent overall survival," said Jeffrey L. Anderson, principal investigator of the study and distinguished clinical and research physician at Intermountain Health. "Our findings show that having little or no coronary plaque predicts that people will live longer, healthier lives, including into their golden years."
A coronary artery calcium score of zero indicates essentially no advanced coronary plaques. A score of 1-99 indicates a mild case of plaque, a score of 100-299 a moderate case, and a score of 300 or more a high case.
The risk of a coronary event in the overall population generally parallels the coronary artery calcium plaque burden, said Dr. Anderson.
In the retrospective study, Intermountain Health researchers identified 40,820 symptomatic patients over a 10-year period who were at primary coronary risk and who underwent a PET/CT scan, which quantifies advanced, calcified plaque is in the vessels of the heart.
Of that overall group, 8,170 patients had a coronary artery calcium score of zero, with 5,185 of those patients under age 65, and 2,782 patients 65 or older. They then assessed coronary prognosis during an average follow up of over 2 years.
Intermountain researchers found that a zero coronary artery calcium score was predictive of a very low risk of coronary death or non-fatal heart attack and of death of any cause.
Coronary events occurred in only 0.12% of younger patients and 0.25% of older patients, a non-significant difference. Comparing overall death or heart attack rates in those with the presence of coronary artery calcium to CAC-zero patients showed two to three-fold lower event rates with zero coronary artery calcium scores in both older and younger age groups, demonstrating the value of a zero coronary artery calcium score at any age.
"If you have disease in your coronary arteries, you may also have vascular complications in other organs of your body," said Dr. Anderson. "Given these results, a zero coronary artery calcium score may also be a predictor of not only very low coronary death but also of a lower risk of other causes of death."
The next step in the research is to further explore the relationship between a zero coronary artery calcium score and all-cause death, including vascular diseases in other organs and even cancer," Dr. Anderson added.
Findings from the Intermountain Health study were presented at the American College of Cardiology's annual scientific sessions conference in Chicago on March 29.
Study Finds Zero Coronary Artery Calcium Score Indicates Strong Prognosis Across Age Groups
Tue 1st Apr, 2025
Recent research conducted by heart specialists at Intermountain Health in Salt Lake City reveals that a zero score on the coronary artery calcium (CAC) scale is a reliable predictor of low risk for cardiac events, regardless of an individual's age. This study analyzed data from over 40,000 patients, demonstrating that having no detectable coronary artery calcium not only correlates with a minimal risk for coronary heart disease but also suggests a significantly lower risk of mortality from any cause.
Traditionally, a CAC score of zero has been viewed as an indicator of very low risk for heart-related issues within the next five years. However, it has long been understood that age significantly influences coronary risk, which intensifies as individuals grow older. The question of whether the risks associated with aging could overshadow the positive implications of a zero CAC score has been a matter of uncertainty until now.
The findings from this large-scale study suggest that a zero CAC score remains a strong indicator of low risk for coronary heart events, even in older adults. Specifically, the researchers discovered that individuals with a zero CAC score had a two to three times lower risk of dying from any cause compared to those with higher scores, demonstrating the vital significance of this marker across all ages.
Dr. Jeffrey L. Anderson, the principal investigator for the study, emphasized the importance of these findings. He noted that the absence of coronary plaque is not only indicative of optimal heart health but also correlates with longevity and overall well-being. A CAC score of zero reflects minimal to no advanced plaque formation in the coronary arteries, while scores ranging from 1-99 indicate mild plaque presence, 100-299 moderate, and 300 or more signify a high degree of plaque burden.
The research team conducted a retrospective analysis of 40,820 symptomatic patients who underwent PET/CT scans over a decade, aiming to quantify calcified plaque in the heart's vessels. Among these patients, 8,170 presented with a zero CAC score, comprising 5,185 individuals under 65 and 2,782 aged 65 and older. The researchers then tracked coronary health outcomes over an average follow-up period of more than two years.
Results revealed that only 0.12% of younger patients and 0.25% of older patients experienced coronary events, indicating a negligible difference between age groups. When comparing overall rates of death or heart attacks among those with detectable coronary artery calcium to those with a zero score, the latter group exhibited significantly lower event rates across both younger and older demographics. This highlights the enduring relevance of a zero CAC score in evaluating cardiovascular health.
Dr. Anderson also pointed out that the presence of coronary disease could indicate potential vascular complications in other organ systems. Therefore, a zero CAC score may serve not only as a predictor of low coronary-related mortality but also of reduced risks associated with various other health issues.
Future research will delve deeper into understanding the relationship between a zero CAC score and overall mortality, including potential connections to vascular diseases affecting other organs and even cancer.
Are You Taking Statins For No Reason? Find Out Here!
Evaluating methods to guide statin prescriptions for heart disease prevention. Not everyone with high cholesterol develops heart disease, and some people with "normal" levels still suffer heart attacks. So how do we determine who is actually in danger? Traditional risk factors like blood pressure, cholesterol, and family history have been used by doctors for years, but they don't necessarily provide the whole picture. The Game-Changer: Coronary Artery Calcium Scoring Recent studies now identify that coronary artery calcium (CAC) score as a superior method. This straightforward, non-invasive test measures calcium accumulation in the arteries, providing a more precise picture of heart health and assisting physicians in making more individualized, accurate judgments on who requires statins! Coronary artery calcium (CAC) scoring is an easy, non-invasive CT scan that quantifies the accumulation of calcium in your arteries, which indicates the risk of heart disease. Approach (1✔ ✔Trusted SourceImpact of Statins on Cardiovascular Outcomes Following Coronary Artery Calcium ScoringGo to source). 'Over 5,600 patients enrolled to assess effective statin prescription strategies. #hearthealth #medindia' Who Really Needs Statins? This Study Has Answers! To identify who benefited the most from statins, the study combined individuals' CAC scoring with conventional risk assessments. Many individuals who were classified as "high risk" using conventional techniques had low calcium scores, indicating that they would not require statins. Significant calcium accumulation, on the other hand, puts certain "low-risk" individuals at higher risk than anticipated. Compared to conventional risk variables like blood pressure and cholesterol, CAC scoring is a more reliable predictor of cardiovascular events because it gives a direct estimate of the load of atherosclerotic plaque.
Not everyone has the same approach for heart disease prevention! Traditional risk assessments do not always provide the whole picture, even though they have been used for years to guide statin prescriptions (2✔ ✔Trusted SourceWho Should Take Statins? A New Study Compares Traditional Risk Factors to Coronary Artery Calcium Scoring in Prescribing Recommendations
Go to source).
Thus, Coronary artery calcium (CAC) scoring is the more precise method in identifying who may or may not require statins. This tailored approach can help cut down on unnecessary medication while guaranteeing that high-risk individuals receive the care they require. If you're worried about your heart health, ask your doctor if a CAC test is right for you!
A Better test means Better decisions and a Healthier Heart for life!
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