The lining tissue of arteries is delicate and easily injured.
They reflect that injury by thickening.
Within the thickened lining is atherosclerotic
plaque which is a mixture of fibrous structural
material, calcium (like that in bone), and
inflammatory cells.
Many plaque components can't be easily measured
in a living human being, such as inflammatory
cells or structural tissue. The calcium
that collects within plaque can be measured
accurately and easily. Microscopic studies
of atherosclerotic plaque have shown that
calcium consistently occupies 20% of the
total volume of plaque. This proportion
remains true for everyone. In other words,
calcium provides an indirect though accurate
means to measure total plaque volume.
Your coronary calcium score predicts your
risk of heart
attack. The higher your heart scan score,
the greater your risk for heart attack.
This is because the more plaque that lines
your coronary arteries, the more opportunity
there is for plaque rupture and heart attack,
even if the plaque is only a 20% blockage.
This remains true even if you feel great,
your cholesterol is low, you're a long-distance
jogger, etc. A heart
scan score is, by far, the most powerful
predictor of your heart’s future.
A common misconception is that, since calcium
is a hard substance, the coronary calcium
score obtained on your heart scan only provides
a measure of hard plaque. Not true. Calcium
measured is a reflection of total plaque,
both soft and hard.
A great majority of people with coronary
plaque have a mixture of hard and soft plaque,
and this can even change day to day, week
to week, since plaque is a dynamic, living
tissue. In other words, a soft plaque today
can develop hard elements tomorrow, and
a hard plaque today can evolve to develop
soft parts any time in future. Most plaques,
in truth, are both. That's why your heart
scan score is such a great measure of hidden,
total, plaque.
You will sometimes hear your calcium score
called an "Agatston" score. It
is named after Dr. Arthur Agatston from
the University of Miami, who first developed
this method of scoring. (This is the same
Dr. Arthur Agatston, by the way, who authored
the hugely successful South Beach Diet.)
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