A simple but little-used clinical procedure has been shown to help doctors determine whether a patient’s high cholesterol levels correlate with excess calcified plaque in their coronary arteries.
So why isn’t it used more often?
A coronary artery calcium (CAC) scan allows cardiologists to create a more personalized treatment plan than they could with just cholesterol or blood-pressure numbers.
“For years, physicians have used risk calculators to determine risk and who should be on statins,” explains integrative cardiologist Mimi Guarneri, MD.
“Unfortunately, the old risk calculators — which are still used today — do not include markers for inflammation or coronary artery calcification.”
The scanning process is quick and noninvasive. But it involves mild radiation exposure and can prompt significant follow-up testing, so some experts believe these drawbacks outweigh the potential benefits.
Yet, as Johns Hopkins University cardiologist Michael Blaha, MD, tells The New York Times, “It’s still being underused compared to its value.”
One obstacle might be price: The procedure can cost $100 to $300 and is not covered by Medicare or most private health-insurance plans.
Another reason may be related to concerns about statins, which are usually the recommended treatment after a high CAC score.
A 2019 survey found that 10 percent of respondents declined a statin prescription, and another 30 percent discontinued their statin use primarily due to a fear of side effects.
The scan does lead to more statin prescriptions, notes Northwestern University cardiologist Philip Greenland, MD, but it also produces “better adherence to statins, less progression of atherosclerosis, and less plaque growth. It tips the scale.”
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