Coronary Calcium: A Key Player in Uncovering Hidden Heart Disease

Although commonly recognized factors such as high cholesterol, high blood pressure, diabetes, and smoking are established risks for heart disease, not every individual experiencing a heart attack exhibits these conditions. Recent research indicates that 14% to 27% of heart attack patients do not present any of these conventional risk factors. New studies talk about the impact of coronary calcium on heart diseases.

A fresh investigation conducted by researchers at Intermountain Health in Salt Lake City reveals a commonality among these patients—they consistently display elevated levels of coronary calcium. The findings from this study emphasize the importance of incorporating scans capable of detecting this type of plaque buildup into standard care protocols. This recommendation holds true even for individuals lacking the four typical modifiable risk factors. By integrating these scans into routine care, healthcare providers can diagnose and initiate treatment for such patients before the occurrence of their initial heart attack event.

“Measuring coronary calcium could have a major impact on how we identify who is at risk for heart disease,” said Jeffrey L. Anderson, lead author of the study and research physician at Intermountain Health. “We need to go beyond just the four major modifiable risk factors because there are risk factors we don’t yet recognize or understand about what’s causing increased risk of heart attack in these patients.”

Results from the research were disclosed at the American Heart Association’s Scientific Sessions 2023 in Philadelphia on November 11, 2023.

The investigation by Intermountain involved the identification of 429 heart attack patients who underwent coronary artery calcium scans. Among these, 369 exhibited standard modifiable risk factors (SMuRF), such as hypertension, hyperlipidemia, diabetes, and/or smoking, while 60 did not have these factors (SMuRF-less).

The researchers assessed the calcium artery scan scores of these patients and examined major adverse cardiovascular events, such as another heart attack, stroke, or death, at both 60 days and in the long term.

The findings revealed that SMuRF-less patients exhibited elevated rates and higher percentiles of coronary calcium scores. Additionally, 77% of these patients met the criteria for preventive therapy, including statins and/or aspirin. As anticipated, patients with SMuRF also demonstrated high coronary artery calcium scores and percentiles. Overall, outcomes were more favorable for SMuRF-less patients and those with lower coronary artery calcium scores.

Despite the increasing prevalence and affordability of coronary artery calcium scans, they have not yet been integrated into the guideline-directed standard of care.

“We’re missing about a quarter of people who are at risk for heart attack events because we’re still relying on just the standard risk factors,” said Dr. Anderson. “We haven’t been doing scans in low-risk patients that don’t have these common risk factors, but that may need to change given our findings, so that we can identify these seemingly low-risk patients who care not, and provide preventive therapy.”

Source – Intermountain Healthcare