Coronary Artery Calcium Scoring a Vital Part of Heart Disease Prevention

Test offers a window into a person’s future risk of a heart attack

DAYTON, Ohio (March 10, 2020) – Cardiovascular disease is the top reason people die across the world each year, yet it’s estimated that a fourth of those individuals never detect the warning signs of a fatal heart-related event, according to the National Institutes of Health (NIH).

“This sad reality makes the use of coronary artery calcium scoring that much more important,” said Mukul Chandra, MD, a cardiologist with Premier Cardiovascular Institute.

Calcium scoring is a non-invasive CT scan (done without needles and dyes) that measures the amount of hard plaque in the arteries of the heart. The more coronary calcium a person has, the greater likelihood that they may develop coronary artery disease, heart attack and death in the future.

“This test is a mammogram for the plumbing of the heart,” said Dr. Chandra, who practices with Premier Physician Network. “Calcium scoring can help us see early signs of heart disease even when a person exhibits no symptoms much like a mammogram helps detect the early signs of breast cancer.”

Dr. Chandra said the ideal candidates are adults between 40 and 80 years of age who are being treated for conditions, such as high blood pressure, cholesterol, diabetes, and smoking, all of which place them at a higher risk for heart disease, or who have a family history of heart disease that begins before age 55.

“This test should be for the 40-year-old diabetic, the 44-year-old whose brother had a heart attack at age 50 or someone who is currently being treated for high blood pressure or high cholesterol,” Dr. Chandra explained.

Calcium scores are measured by number from zero to 400 and beyond, Dr. Chandra said. These scores fall into one of three main categories, which help determine what type of treatment a person might need.

The gold standard – The best score anyone can have is zero, which means there is no presence of calcium. This score can be a reassurance to a person that they are already taking steps to lead a healthy life, and that they carry a very low risk for developing heart disease over the next 10 years, Dr. Chandra said.

Sitting on middle ground – A score between one and 99 is considered mild, and a score ranging from 100 to 400 is moderate. Those who fall in this range will be advised on lifestyle changes that can help reduce their risk for developing heart disease. This may include implementing a Mediterranean diet and beginning a regular exercise routine. They may also be candidates for statins (cholesterol-lowering medications).

A reason for concern – Scores of 400 and above are considered severe. Those who have this score will likely have to make changes beyond just diet and exercise to include the use of a cholesterol-lowering medication. As the score becomes higher, it becomes more likely that a cardiac incident could happen sooner. In the presence of symptoms of chest pain or shortness of breath, they may be advised to undergo a stress test.

“I have seen many patients who have had a score of 1,000, and we know that they carry an 80 percent chance of having a heart attack within just five years,” Dr. Chandra said.

Patients will receive their raw score (zero to 400 or beyond), but also be given a percentile. The raw score shows how much calcium is in the arteries, whereas the percentile shows where a person’s score falls among others their age and gender and gives greater clarity to the severity of their case.

“A score of 10 may seem low,” Dr. Chandra said. “But that score means something very different if the person is 40 years old compared to if they are 60 years old.”

Calcium scoring is extremely accurate, and while meant to be done just once in a lifetime, can be repeated over time (5 years) to reassess risk.

For more information about calcium scoring, visit, or to schedule an appointment with a Premier Physician Network physician near you, visit

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