This is local guidance based on National consensus advice from the British Society of Cardiac Imaging and British Society of Cardiac CT.
Rational: Coronary artery calcium (CAC) is specific for coronary artery atheroma and can be seen on CT scans of the thorax. There is strong evidence that increasing levels of CAC are associated with worse prognosis and an increasing level of obstructive coronary artery disease.
There is some evidence that preventative measures (that is risk modification and the use of statins) improve prognosis.
It follows therefore that in such patients in who CAC has been detected:
- Consideration for the provision of risk modification and statins should be given. Clearly this will be dependent on patient preferences and comorbidities and the decision will be reliant on discussion with the patient.
- That the patients should be questioned if they have cardiac sounding chest pain as per NICE CG 95. If this is the case consideration for further investigation should be given. In view of its very high negative predictive value this should either be for referral for a cardiac CT scan directly, or if there is clinical doubt the patients could be referred to the Rapid Access Chest Pain Clinic as usual.