AIM: CT more useful to detect calcium buildup, indicating heart risks in women

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A new analysis of the Multi-Ethnic Study of Atherosclerosis (MESA) shows that a third of women considered to be low risk based on the Framingham Risk Score (FRS) had detectable coronary artery calcium (CAC) on a CT scan and were at increased risk for coronary heart disease (CHD) compared with those without detectable CAC, according to a new study published in the Dec. 10/24 issue of the Archives in Internal Medicine.

Women are more likely to die from cardiovascular disease than all cancers combined, according to current American Heart Association statistics.

In a landmark MESA study, Susan Lakoski, MD, of the Wake Forest School of Medicine in Winston-Salem, N.C., examined 3,601 women aged 45 to 84 and measured their CAC by a CT scan, excluding those with diabetes and over 70 years old. Ninety percent of the women in MESA were classified as low-risk based on FRS.

The researchers found that the FRS defines the CHD risk in 95 percent of women. In low-risk patients, 32 percent were found to have CAC present on cardiac CT imaging. There was a six-fold greater risk for a CHD event including sudden cardiac death and myocardial infarction in women with any CAC compared with women with no detectable coronary calcium in this low FRS population.

In an accompanying editorial, Sarah Rosner Preis, MD, and Christopher J. O'Donnell, PhD, of the Framingham Heart Study in Massachusetts, said the results, “raise the important question of whether CAC screening is warranted among at least some women who are currently classified as low risk.” The authors concluded that, for a number of reasons, it is still too early for this recommendation.