Preventative Scanning Screening using the Coronary Artery Calcification Scan
Coronary artery calcification (CAC) scan (also known as calcium scan test) is a CT scan of your heart that detects and measures the amount of calcium present in the walls of your coronary arteries. This allows CAC scans to be used as a preventive screening measure for coronary heart disease (CHD) to better manage at-risk and asymptomatic patients alike. A panel of expert cardiologists that presented during Right Care Initiative 2015 Summit provided us with data showing that use of CAC scanning can be used as a marker of CHD and improve outcomes.
The following algorithm is a recommendation from that panel:
CAC Expert Panel – (Presentation) (Video Part 1 | Part 2 | Part 3)
Right Care Initiative Research Team Coronary Artery Calcium Brief: Coronary Artery Calcium Heart CT Screening for Early Detection of Atherosclerotic Plaque: Measuring Heart Attack Risk to Determine Need for Preventive Medication
Coronary Artery CT Scans are available for $200 or less at many leading medical centers including the following in three major metro areas where the Right Care Initiative is active (Sacramento, Los Angeles, and Santa Clara Counties):
- 3 Preventive Cardiology programs at major medical centers have taken a leadership role in lowering the barrier to receiving the Coronary Artery Calcium preventive screening (CT Heart Calcium Score) by offering it along with a preventive cardiology visit to patients for a low cash price to receive this precision prevention information for understanding patients’ actual risk profile: Stanford Health Care, LA BIOMED (affiliated with UCLA), and UC Davis Medical Center. Contact information is below.
- Stanford Preventive Cardiology Clinic Appointment Line: 650-725-5909
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LA BIOMED Medical Center Appointment line: (310) 222-2773; HTTPS://LABIOMED.ORG/MATTHEW-J-BUDOFF-MD
- UC Davis Health Referrals for CT Coronary Calcium:
- To Schedule appointments: Call 916-734-0655 or fax request to 916-734-2254. Include on fax or be prepared to provide on telephone: Full name, address, Date of Birth, telephone #, emergency contact (optional), Any Relevant Existing Diagnosis, Exam Requested: CT Coronary Calcium Scoring. Bring to test appointment: ID, Debit, Credit, or ATM card.
- In Wisconsin, Gundersen Health System:
- CT Clinical Manager — Imaging Scheduling (608) 782-7300 ext. 53666
Additional Literature on Guidelines, Treatment and Recommendations for Asymptomatic Adults and CAC Scores
- 2010 ACCF/AHA Guideline for Assessment of Cardiovascular Risk in Asymptomatic Adults
- Arad et al. Treatment of Asymptomatic Adults with Elevated CAC Scores. JACC. 2005
- Mulders et al. Asymptomatic Individuals with family history for premature CAD and evevated CAC scores. St. Francis Heart Study.
- Rozanski et al. Impact of CAC Scanning on Coronary Risk Factors. JACC 2011
- Shaw et al. Induced Cardiovascular Procedural Costs and Resource Consumption Patterns after CAC Screening. JACC 2009
- Perrone-Filardi et al. CAC Recommendations ESC EHJ 2010
- 2013 ACC AHA Guideline on Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults
Cardiovascular Risk Calculators:
- Astro-CHARM – 10-Year ASCVD Risk Calculator with Coronary Artery Calcium
- American College of Cardiology atherosclerotic cardiovascular disease (ASCVD) risk calculator tool:
Supplemental Information:
- Irish Heart Disease Awareness’ video Widowmaker (discusses evidence-base for using the CAC scan for proactive screening similar to a mammogram for the heart, but with much less frequency): Irish Heart Disease Awareness – Heart Attacks, The Facts
- Studies Featured:
- The St. Francis Heart Study (Treatment of Asymptomatic Adults With Elevated Coronary Calcium Scores With Atorvastatin, Vitamin C, and Vitamin E)
- The EISNER Study (Early Identification of Subclinical Atherosclerosis by Noninvasive Imaging Research)
- The Courage Trial (Optimal Medical Therapy with or without percutaneous coronary intervention (PCI) for Stable Coronary Disease)
- 2010 ACCF/AHA Guideline for Assessment of Cardiovascular Risk in Asymptomatic Adults
- 2013 European Society of Cardiology Guidelines on the Management of Stable Coronary Artery Disease
- Studies Featured:
- In the news: CAC Score Helps Calculate More Accurate Atherosclerotic CVD Risk
- CAC Scan Facts
- SHAPE 2 Guidelines 2014
- CSANZ CAC Algorithm
Right Care Initiative Lectures:
11th Annual Right Care Initiative Clinical Performance Improvement Leadership Summit
- Lifetime Achievement Award for Leadership of CARDIA Study Illuminating Importance of Coronary Artery Calcium Plaque in the Young for Triage
- Stephen Sidney, MD, MPH, Director of Research Clinics & Senior Research Scientist, Kaiser Permanente Northern California Division of Research (Presentation) (Video: Part 1, Part 2)
8th Annual Right Care Initiative Leadership Summit
- Precision Medicine for Early Detection and Treatment of Coronary Artery Disease for People without Symptoms – Preventive Cardiology Expert Panel (Presentation) (Video Part 1 | Part 2 | Part 3)
- Panel Introduction & Patient Story
- Warren Barnes, JD, M. Divinity, Regulatory Consultant, UC Berkeley School of Public Health; retired chief of legal for DMHC; and co-founder Right Care Initiative
- Panel Chairman: David J. Maron, MD, FACC, FAHA, Clinical Professor of Medicine, and Director of Preventive Cardiology, Stanford University School of Medicine
- Arthur Agatston, MD, Medical Director of Wellness and Prevention, Baptist Health
- Daniel S. Berman, MD, Chief, Cardiac Imaging and Nuclear Cardiology, Cedars Sinai
- Mathew Budoff, MD, Professor of Medicine, UCLA; Endowed Chair of Preventive Cardiology and Cardiology Program Director, LA Biomedical Research Institute
- Mary Ann Champagne, RN, MS, Clinical Nurse Specialist, Stanford Medical Center
- Michael V. McConnell, MD, MSEE, Professor of Medicine (Cardiovascular) and of Molecular and Cellular Physiology and of Electrical Engineering, Stanford University
- Morteza Naghavi, MD, Founder, Society for Heart Attack Prevention & Eradication
- Ian S. Rogers, MD, MPH, Clinical Assistant Professor of Medicine, Stanford University
- *Expert panelists participating in absentia:
Vice Chairman: *James K. Min, Professor of Medicine, Weill Cornell Medical College,
*Prediman Krishan Shah, Professor of Medicine and Cardiology; Director, Oppenheimer Atherosclerosis Research Center; Director, Atherosclerosis Prevention and Treatment Center, Cedars Sinai Medical Center
*Leslee Shaw, PhD, Professor of Medicine (Cardiology), Emory School of Medicine
- Panel Introduction & Patient Story
LA University of Best Practices:
May 20, 2016
- “Coronary Calcium Scoring for Risk Stratification and Guidelines”
- Matthew Budoff, MD, FACC, FAHA, Endowed Chair of Preventive Cardiology Professor of Medicine, Director, Cardiac CT, Harbor-UCLA Medical Center, Torrance, CA. (Presentation)
Sacramento University of Best Practices:
May 11, 2020
- Mother-Daughter Patient Story (Presentation | Video)
- Riya Pulicharam, MD, National Medical Director for Population Health, Healthcare Partners
September 9, 2019
- Groundbreaking Findings from the CARDIA Study & Impact of Coronary Artery Calcium on Adults (Presentation)(Video – Part 1 , Part 2)
- Stephen Sidney, MD, MPH, Director of Research Clinics & Senior Research Scientist, Kaiser Permanente Northern California Division of Research
January 8, 2018
- Coronary Calcium Scanning for Prevention Action (Presentation)
- William J. Bommer, MD, Executive Committee, American College of Cardiology, CA; Division of Cardiovascular Medicine, UC Davis
Silicon Valley University of Best Practices:
November 27, 2018
- A Scientific Convening on Coronary Calcium’s role in ASCVD Precision Medicine
- Co-Chair Vision, Welcoming Remarks
- Family Perspective on Coronary Calcium Screening
- Victoria Dupuy – Founder & Executive Director, No More Broken Hearts Foundation; Along with Survivors (Presentation)
- Coronary Calcium Testing at the Stanford Preventive Cardiology Clinic
- David J. Maron, MD – Director, Preventive Cardiology; Clinical Prof. of Medicine, School of Medicine, Stanford University
- Evidence for Finding and Treating Atherosclerosis Before Patients are Symptomatic
- Matthew Budoff, MD – Prof. of Medicine, Endowed Chair of Preventive Cardiology, School of Medicine, UCLA; Program Director, Division of Cardiology Los Angeles Biomedical Research Institute; Steering Committee Member, Director CT Reading Center, Multi-Ethnic Study of Atherosclerosis (MESA) Trial
- US Preventive Services Task Force’s Insufficient Evidence Recommendation & Next Steps
- Doug Owexns, MD, MS – Prof., School of Medicine, Stanford University; Incoming Chair, US Preventive Services Task Force (Supplement 1, Supplement 2, Supplement 3)
- Payer Perspective
- Scott Flinn, MD – Regional Medical Director, Blue Shield of California; Former Co-Chair, San Diego Right Care University of Best Practices (while Arch Medical Group CMO); Former U.S. Navy Medical Officer
- Carol Zaher, MD, MPH, MBA – Board Certified Cardiologist & Medical Director, Health Net California Medical Management, Centene; Los Angeles University of Best Practices Co-Chair, Right Care Initiative
- Moderated Around-the-Room Q &A, Planning & Action Discussion: Silicon Valley Quest to Get to Zero Preventable Heart Attacks, Strokes & Diabetes Deaths and Disabilities
- Robert Kaplan, PhD – Right Care Initiative Technical Expert Group; Adjunct Prof., School of Medicine & Research Director, Clinical Excellence Research Center, Stanford University; Former Chief Science Officer US HHS AHRQ; Retired, Associate Director, National Institutes of Health
- David J. Maron, MD – Director, Preventive Cardiology; Clinical Prof. of Medicine, School of Medicine, Stanford University
Last Updated: 6/18/20