For years, we have estimated cardiovascular risk using formulas that take into account factors such as cholesterol, blood pressure, smoking, diabetes, and age. However, these estimates don’t always reflect clinical reality: some patients with “normal” risk factors suffer heart attacks, while others with abnormal values may never experience any events.
We’ve become used to talking about preventive medicine… but we still don’t really prevent. We undergo mammograms, colonoscopies, or chest CT scans to detect cancer before it’s too late — yet the heart, still the leading cause of death in Spain and worldwide, is often ignored until symptoms appear.
Perhaps it’s time to change the paradigm: instead of waiting for cholesterol to rise or the ECG to show abnormalities, let’s actually see how our arteries are doing.
What is the Coronary Calcium Score?
The Coronary Calcium Score, also known as the Agatston Score, is a quick, painless, contrast-free CT scan that quantifies the calcification of the coronary arteries, a direct marker of subclinical atherosclerosis. This test can predict the risk of coronary events years before symptoms appear, particularly in patients with intermediate risk.
At CreuBlanca, the Calcium Score is performed using the latest-generation Multidetector CT, allowing for a precise and non-invasive assessment of the coronary arteries. This technique is used to detect calcium deposits in the coronary arteries, providing crucial information for cardiovascular risk stratification.
Clinical Benefits
- Objective risk reclassification: A patient with intermediate risk and a Coronary Calcium Score = 0 has an excellent prognosis; another with a Score >100 requires a much more aggressive approach.
- Quick, non-invasive, and low-radiation procedure: The radiation dose is similar to that of a mammogram, with results available within minutes.
- Personalised medicine: Helps determine who truly needs statins or further tests and who doesn’t. It avoids both overmedication and false reassurance, as not all “at-risk” patients are actually ill, and not all “healthy” ones are safe.
Scientific Evidence
Numerous studies show that the Coronary Calcium Score allows for a more accurate identification of who is truly at risk of cardiovascular disease and who can simply maintain basic preventive measures.
- A Coronary Calcium Score of 0 is associated with less than 1% of cardiovascular events over 10 years, meaning these patients can focus on maintaining a healthy lifestyle and routine check-ups.
- A Score above 400 reflects a significant build-up of calcium in the arteries, multiplying the risk of heart attack or cardiac death by 10; in such cases, a full cardiology evaluation and intensive follow-up are recommended.
In addition, incorporating the Calcium Score into traditional risk prediction models, such as SCORE2, Framingham, or QRISK, significantly improves the identification of at-risk patients, enabling more accurate stratification and personalised clinical decisions.
Clinical Applications
In clinical practice, this information helps define each patient’s preventive strategy:
- Low risk and Score = 0: maintain healthy habits and routine follow-up.
- Intermediate risk and Score > 100: start pharmacological prevention and closer monitoring.
- High risk and Score ≥ 400: referral for full cardiology assessment and intensive preventive measures.
In short, the Coronary Calcium Score translates findings into clear clinical decisions, helping to prevent both overmedication and a false sense of security.
Conclusion
The Coronary Calcium Score should be part of everyone’s preventive health check-up, especially in patients with intermediate risk or a family history of heart disease. It’s not an optional tool: it’s an evidence-based, accurate, and proven method with a real impact on cardiovascular prevention.
The medicine of the future should not only predict risk but also measure disease before symptoms appear. Why wait for symptoms to check your heart? The Coronary Calcium Score is more than just an image — it’s a window into the future of your heart, allowing early detection of subclinical atherosclerosis, guiding medical decisions with precision, and improving cardiovascular prevention in an objective, evidence-based way.