Harvey Hecht, MD, discusses two studies evaluating utility of CAC screening

WASHINGTON — In this video, Harvey Hecht, MD, associate director of CV imaging and professor of medicine at Icahn School of Medicine at Mount Sinai in New York, highlights two studies presented at the American College of Cardiology Scientific Sessions that assessed the utility of coronary artery calcium screening.

One study, which evaluated CAC screening in a cohort of 946 asymptomatic patients compared with a treadmill stress test, indicated that CAC score was more predictive of poor outcomes during a 10-year follow-up period. The difference between screening methods was particularly pronounced among the approximately 80% of participants who were considered low risk according to the treadmill test results. Hecht said that clinicians considering a stress test in this population should instead perform a CAC evaluation, as it will provide better risk assessment.

In a separate presentation, researchers conducted a meta-analysis of 17 studies assessing the link between CAC score and risk for myocardial ischemia. This trial indicated that a score of 400 or higher was predictive of increased ischemia prevalence, while a score below 100 was indicative of reduced risk. Hecht said that a stress test should not be performed in patients with a CAC score below 100, because of the low likelihood of positive results, while a patient with a score above 400 is an ideal candidate for testing due to the increased likelihood of ischemia. He concluded that coronary calcium has the potential to change how stress testing is viewed, and that a CAC score should be obtained before performing stress testing, regardless of whether a patient is symptomatic.