Yet Another Test for Heart Disease Risk?

"Calcium scanning has achieved a cult-like following in spite of its relative limited value and high costs. Perhaps more disturbingly, calcium scanning often leads to other unnecessary testing, including cardiac catheterization, which probably explains its popularity in our 'fee for service' health care environment."

The amount of radiation was an issue of contention for some. "The radiation exposure is a concern," said Dr. Randy Wexler, associate professor of clinical medicine at Ohio State University. "It does not stop at one test. I have yet to have a patient go and obtain CACS without the recommendation always being a repeat sometime down the road. More cost. More radiation."

But some doctors saw greater value in the CACS because it might help a doctor convince a patient that lifestyle changes are necessary.

"Consider a forty-ish man with high cholesterol, stage 1 hypertension, and pre-diabetes whose father had [a heart attack] in his 50's and who refuses to take a statin or exercise," said Dr. John Messmer, an associate professor of family and community medicine at the Penn State College of Medicine.

"A high [CACS] could be useful to show him he already has atherosclerosis and should be working aggressively to lower his risk," he said.

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