Coronary artery calcium scores may improve heart disease-risk predictions

The image shows early signs of plaque accumulation.

Detecting the earliest signs of plaque formation through coronary artery calcium scores improved 10-year risk predictions for coronary heart disease, according to research published in JAMA. The study was partially supported by NHLBI.

To gauge a person’s risk for having a heart attack or stroke, doctors often use calculators that assess their age, underlying conditions, and indicators of cardiovascular health, including blood pressure, blood sugar, and cholesterol. That computation, or projected risk, generally falls into high, intermediate, borderline, or low categories. People with elevated risks for heart disease may take therapies to lower their cholesterol and blood pressure. Adults with or on the cusp of having intermediate risks may schedule additional tests to further assess their risk.

To evaluate ways to better personalize these risks, researchers studied if two assessments – both of which can improve risk predictions – could improve 10-year risk calculations. The assessments included coronary artery calcium scans and polygenic risk scores, which provide general insight about genetic risks. After reviewing data from more than 3,000 adults, ages 45-79, from the United States and the Netherlands, the researchers found coronary artery calcium scans significantly improved 10-year risk predictions for heart disease, but the polygenic risk scores didn’t have the same effect.

The authors explained genetic risks may be more useful for younger and middle-aged adults. Alternatively, older adults or adults with underlying risks may benefit more from learning about early signs of plaque accumulation. This could then inform decisions they make with their physician to manage risks.