The level of calcium in the arteries may be an effective way of predicting risk of heart attack and stroke, researchers say today.
It may be more effective than the alternative of looking at the amount of C-reactive protein, researchers say.
Research carried out by John Hopkins University in the USA concluded that examining coronary artery calcium (CAC) could identify people who would benefit from statins to reduce their risk of heart disease, even if they have normal cholesterol levels.
Authors of the study, which is published in The Lancet, said it provided “clear evidence” that high levels of calcium in coronary arteries increases the risk of heart attack or stroke.
Heart specialist Dr Michael Blaha, who led the study, said: "While not everyone needs a calcium scoring test, we believe looking for calcification in coronary vessels in certain patients makes sense in order to predict who may benefit from statin therapy because the test gets right to the heart of the disease we want to treat.”
The research, which followed 2,083 people for six years, found that 95 per cent of the heart attacks, strokes or heart-related deaths in the study population occurred in people with some measurable calcium in their heart arteries.
High levels of C-reactive protein in the blood, a score at or above 2 milligrams per litre, offered little predictive value.
"Many patients fall into the grey zone of being healthy with normal LDL cholesterol, but also having some risk factors, including being overweight, having elevated blood sugar levels or a family history of heart disease,” says co-author Dr Roger Blumenthal.
“Our study provides clear evidence that high levels of calcium in coronary arteries will increase the risk of a heart attack or a stroke. And the risk increases with the amount of calcium, whether or not patients have high levels of C-reactive protein."
Professor Peter Weissberg, medical director at the British Heart Foundation, said because calcium testing is expensive and involves radiation, it is “unlikely to be offered as a screening test for everyone”.
“Nevertheless, it’s likely it will be increasingly used in the coming years to refine how we identify those most in need of preventive medicines,” he adds.
In a linked Comment, Dr Axel Schmermund and Dr Thomas Voigtländer, Cardioangiologisches Centrum Bethanien, Frankfurt, Germany, say they are already incorporating calcium testing into the treatment strategies at their clinic.
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