A CT imaging technique called a coronary artery calcium scan can detect heart disease decades before symptoms appear, according to a review recently published in JACC: Cardiovascular Imaging.

It's standard protocol to screen patients for breast, colon and lung cancer before symptoms are present. But there is currently no consensus among physician groups regarding when to use cardiac imaging to screen for heart disease.

Patients are usually evaluated with a combination of historical data and blood tests that measure serum lipids and blood glucose levels. A risk score is then generated to help the physician predict if the patient will develop heart disease.
A CAC scan is capable of detecting even small amounts of CAC. The scan results are recorded using a CAC score, which represents the total amount of CAC in the coronary arteries, and the higher the score, the greater the risk for heart disease.

Performing CAC scans on the most cutting-edge CT scanners only exposes patients to a very small amount of radiation. It's also less expensive than other imaging modalities.

For the review, the researchers looked at five clinical trials with a total of 4,615 participants who did not show signs of heart disease. One trial used cardiac stress imaging, three used CAC scans and one involved noninvasive coronary CT angiography.

They found that since modern medicine has dramatically reduced the rate of the most serious consequences of heart disease, it might be hard to prove that imaging techniques can reduce cardiac death in clinical trials.

Instead, they are interested in investigating whether CAC scanning and other imaging techniques can improve patients' overall cardiac risk profile without increasing medical costs. One of the trials called the EISNER trial proved that it can do just that.

The researchers concluded that there is now "sufficient evidence" to support the routine use of CAC scanning for screening patients for heart disease. If problems are detected early on, patients have the opportunity to make lifestyle changes to avoid developing heart disease.

"We believe this will not only help improve and save lives but that it can ultimately contribute to lower health costs, since the earlier adoption of positive health habits can reduce patients' clinical risk and potentially eliminate the need for more costly interventions later on," Dr. Alan Rozanski, chief academic officer and director of the cardiology fellowship training program for the division of cardiology at Mount Sinai St. Lukes Hospital, said in a statement.

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