The Test You Want a Zero On

A couple weeks ago, I posted I was going in for a CT Angiogram to get a Coronary Artery Calcium (CAC) Score. The CAC score, which is a measure of how much calcium has built up in your heart, can be anything from a zero to over 1000. Generally speaking, the higher your CAC score, the higher the risk that you'll have a heart attack.

When combined with something like the MESA Risk Calculator, which only takes into account things the kinds of things a doctor can assess in their office, the CAC score is significantly associated with the occurrence of major cardiovascular events, which includes all-cause mortality, cardiac mortality, and nonfatal myocardial infraction.

Knowing your score, as Ivor Cummins says, really helps you understand your risk of cardiovascular events. He covers this quite succinctly on a recent episode of his podcast. While he publishes his podcast in audio form, I highly recommend watching Episode 12 which includes all the graphs.

I finally got the results of the test today. The result: a CAC score of zero. Based on that score alone, my risk of a cardiovascular event over the next couple years is less than 2%. I still have elevated blood pressure, and technically a diabetic, so my risk is a little higher according to the MESA Calculator—about 3%. Which is still pretty low in the grand scheme of things.

More importantly, it means I don't need to take a statin, which my doctor has been trying to get me to take again in light of my higher than normal cholesterol. With my risk profile and a CAC score of zero, statin use is not warranted.

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