February 7th, 2023

National Trends in Coronary Artery Disease Imaging Associations With Health Care Outcomes and Costs

Background In 2016, the National Institute for Health and Care Excellence Clinical Guideline Number 95 (“Chest pain of recent onset”) (CG95 recommended coronary computed tomography angiography (CCTA) as the first-line for possible angina.

Objectives The purpose of this study was to determine the impact of temporal trends in imaging use of outcome for coronary artery disease (CAD) following the CG95 recommendations.

Results

There was a rise in CCTA, decrease in myocardial perfusion imaging, and a modest fall in invasive coronary angiography. There was an apparent trend between computed tomography angiography growth and invasive catheter angiography reduction across regions.

CCTA growth was associated with a reduction in cardiovascular mortality, and ischemic heart disease deaths with an apparent trend with reduced all-cause mortality.

Conclusions

Imaging investigations for CAD are increasing. Greater regional increases in CCTA were associated with fewer hospitalizations for myocardial infarction and a more rapid decline in CAD mortality. (J Am Coll Cardiol Img 2022;-:-–-) Crown Copyright © 2022 Published by Elsevier on behalf of the American College of Cardiology Foundation. All rights reserved.

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New Cardiac CT site opened in the Mountain Region of Colorado!

Another successful initiation of cardiac CT program happened last week. In Colorado mountain region where patients frequently must be air transferred to the nearest cath lab, a CCTA can significantly improve care of local patients and visitors by rapid triaging of acute patients and avoiding many unnecessary transfers to Denver.

This program will serve residents by facilitating earlier diagnostic workups for chest pain and keeping patients local, decreasing the amount of travel required to care. This cardiac CT program is also equipped with some of the newest AI programs that supplement anatomical CT images with plaque analysis and CT FFR information, providing more information to support physicians with treatment planning.

How can cardiac CT support your program with early diagnosis and keeping patient care local?

March 25th, 2024

Cracking the Code: How Coronary Calcium Scans Unlock Heart Health Secrets

Medical technology advancements have paved the way for early detection and the prevention of heart-related issues. One such groundbreaking diagnostic tool is the coronary calcium scan. This non-invasive imaging procedure plays a crucial role in assessing the risk of heart disease by detecting the presence of calcified plaque in the coronary arteries.

We spoke to Katarina Nelson, MD, FACC, a non-invasive cardiologist specializing in general cardiology, preventive care, women and heart disease, and a wide range of cardiovascular imaging. She joined CommonSpirit Health at the St. Anthony Hospital in Summit in August 2022.

February is American Hearth Month

We asked Dr. Nelson to share a few heart health statistics with us to recognize American Heart Month. She told us, “Cardiovascular disease is the leading cause of death in the U.S. for both men and women. There are 400,000 deaths a year among women and 386,000 deaths among men a year in the U.S. Coronary Artery Disease (CAD) alone is the cause of 175,000 deaths a year. This makes CAD the most common cause of mortality among adults in the United States.

“While common, it is preventable,” Dr. Nelson emphasized, reminding us that “CAD and its risk factors can be screened, identified, and treated early.”

Understanding Coronary Calcium Scans

A coronary calcium scan is a specialized imaging test using computed tomography (CT) technology to create detailed images of the coronary arteries. The primary purpose of this scan is to identify and quantify the amount of calcium deposits in the coronary arteries, which are indicative of atherosclerosis or plaque buildup.

Calcium deposits in the coronary arteries are a key marker of atherosclerosis, a condition characterized by the hardening and narrowing of the arteries. As plaque accumulates over time, it can restrict blood flow to the heart, leading to cardiovascular issues, including heart attacks. “The calcium score, also known as the Agatson score or coronary calcium CT scan, is a special computerized tomography (CT) scan of the heart,” Dr. Nelson said. “It looks for calcium deposits in the heart arteries.

“Coronary calcium scan results can help determine the risk of heart attacks or strokes, and the results from the scan can guide therapies for coronary artery disease.”

How Can It Save Your Life?

The information obtained from a coronary calcium scan is invaluable in assessing an individual’s risk of developing heart disease. By identifying the presence and extent of calcified plaque, healthcare professionals can gauge the severity of atherosclerosis and tailor a preventive strategy accordingly.

Early detection through a coronary calcium scan allows for timely intervention, enabling individuals to make lifestyle changes, initiate medications, or undergo medical procedures to prevent the progression of heart disease. This proactive approach significantly reduces the risk of heart attacks and other cardiovascular events.

How Can You Get a Coronary Calcium Scan?

Getting a coronary calcium scan involves consulting with a health care provider, who will assess your risk factors for heart disease. Common risk factors include age, family history, smoking, high blood pressure, and high cholesterol levels. Your provider may recommend a coronary calcium scan to evaluate your cardiovascular health based on the evaluation.

The procedure itself is quick, usually taking 15 minutes or less, and painless. During the scan, you lie on a table that slides into the CT scanner. The scanner captures detailed images of your heart, and the results are analyzed to determine the presence and extent of calcium deposits.

Popularity of Coronary Calcium Scans

The popularity of coronary calcium scans has steadily increased as awareness of preventive cardiology grows. Many recognize the importance of early detection and intervention to safeguard their heart health. Health care providers also incorporate these scans into routine screenings for individuals at risk of heart disease.

The availability and recommendation of coronary calcium scans may vary based on geographical location, health care infrastructure, and individual risk profiles. However, the rising prominence of preventive health care is contributing to the widespread adoption of these scans in many regions.

Who Benefits Most?

“The calcium score is best for asymptomatic patients with no known coronary artery disease, who are over 45 years old with a strong family history of early coronary artery disease, borderline or elevated lipids to guide treatment decisions for cholesterol management and potential further testing.”

Dr. Nelson

It is not, she warned, the best course for those at high risk of heart attacks or who have previous heart conditions.

“It is a screening tool for coronary artery disease equivalent to a mammogram for breast cancer or colonoscopy for colon cancer,” Dr. Nelson said. She described a recent 46-year-old active patient with a significant family history of premature coronary artery disease. Telling us his risk factors, she said, “His father died of myocardial infarction at age 42, and his first cousin underwent bypass surgery at age 40.” The scan showed a high calcium score, which led to further workup that showed critical stenosis or blockage in one of the main coronary arteries. “He was treated with coronary artery stenting to open the pathway and to prevent heart attacks and sudden cardiac death.”

Next Steps

The decision to undergo a coronary calcium scan should be in consultation with a health care provider. Before recommending the scan, they will assess your overall health, medical history, and risk factors. Additionally, guidelines may vary, and health care professionals will consider individual circumstances when making recommendations.

In the quest for optimal heart health, coronary calcium scans emerge as a powerful tool for early detection and prevention of heart disease. By providing crucial insights into the presence of calcified plaque in the coronary arteries, these scans empower individuals and health care professionals to take proactive measures to mitigate cardiovascular risks. As awareness grows, the coronary calcium scan will play a pivotal role in preventive cardiology, ultimately saving lives through early intervention and personalized care.