Calcium Scans Help Predict Coronary Risk

(HealthDay News) -- Scanning the heart arteries for calcium deposits can help predict future cardiac problems, a new study shows, but experts aren't sure that adding such scans to routine checkups would be worth the cost.

"It has been shown to be predictive" of potential heart trouble, said Dr. Diane Bild, deputy director of the division of prevention and population sciences at the U.S. National Heart, Lung, and Blood Institute, which funded the study. "Whether it is actually beneficial to the people who are screened has not been shown."

A calcium scan using computed tomography (CT) costs $300 to $600. These scans look for calcification -- hardening of the arteries caused by high blood fats and calcium deposits that can eventually cause blood vessel blockage. The scan is a potential competitor for much less expensive tests for coronary risk, such as blood cholesterol and blood pressure readings.

The new study involved more than 6,700 American men and women across a number of racial and ethnic groups -- white, black, Chinese, Hispanic -- who were followed for an average of 3.8 years. It found that the risk of a coronary event was nearly 10 times higher for those with the highest calcium deposit scores than for those with the lowest.

"This study was launched in 1999, a time when there was a lot of interest in whether this new test could predict coronary artery disease," Bild said. "A lot of studies have been done in predominantly white populations. This was one of our efforts to include minority groups."

The study does show that calcium scanning "modestly improves predictions over traditional risk factors," she said. "Several pieces of information are needed in order to understand whether this is clinically useful."

The findings are published in the March 27 issue of the New England Journal of Medicine.

The cost of such scans could be reduced, according to a statement from study lead author Dr. Robert Detrano, professor of radiological sciences at the University of California, Irvine, who is traveling in China. Scans have been done for just $30 in China, Detrano noted.

"It is mostly an issue of cost," said Dr. William S. Weintraub, chief of cardiology at the Christiana Health Care System, the largest health-care system in Delaware, who wrote an accompanying editorial in the journal. "It does add to our discrimination, but it costs a couple of hundred dollars and we're not sure how you use it."

Reducing the cost would make the test more usable, and "more epidemiological studies showing its value in risk prediction would be of great value," Weintraub said.

"But I'd be uncomfortable now with the idea of recommending this for everybody, or even defining a middle ground where we are unsure how we treat people so they get this first," he said.

A calcium scan also carries some risk, since it exposes a person to radiation, Bild noted. "It would be worth it if the benefit outweighed that risk," she said. "We don't clearly have both sides of that equation established."

More information
For more on coronary calcium scans, visit the U.S. Heart, Lung, and Blood Institute.

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Urine Test Results Can Point to Heart Dangers

(HealthDay News) -- Even a small amount of a protein called albumin in the urine of patients with stable coronary artery disease increases their risk of cardiovascular death, say U.S. researchers.

The findings from this study of almost 3,000 patients, age 50 and older, with stable coronary artery disease (CAD) have implications for assessing and perhaps treating patients with vascular disease.

The study was published in the current issue of the journal Circulation.

Albumin is normal and necessary in blood, but its presence in urine indicates leakage in the kidney filtration system and possible damage to cells that line the kidney's blood vessels, according to background information in the study.

"We found that virtually any degree of albuminuria, even albumin below the level we call microalbuminuria, placed a patient at significantly higher risk of cardiovascular events," lead author Dr. Scott D. Solomon, associate professor of medicine at Harvard Medical School and director of Noninvasive Cardiology at Brigham and Women's Hospital in Boston, said in a prepared statement.

He and his colleagues also found that the hypertension drug trandolapril (an ACE inhibitor) lowered albumin levels in patients' urine.

The findings of this study and previous research by the same team indicate that "we cardiologists need to pay more attention to kidney function in our patients, and we need to look at two aspects -- filtration and albuminuria," Solomon said.

"It is important for cardiologists to understand that these are not patients who will even come to dialysis or even necessarily see a nephrologist," he said. "But they do have mild kidney disease that puts them at increased risk for a cardiovascular event."

More information
The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about protein in urine.
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