Cardiac CT for Coronary Artery Calcium Scoring at No Cost
Noninvasive atherosclerosis imaging provides more accurate and earlier detection of coronary heart disease than traditional risk scoring algorithms or empiric clinical judgment.
Make a Referral
To order a CACS test, call 216-844-1700.To refer a patient for UH Preventive Cardiology, call 216-844-5965 or email CVPrevention@UHhospitals.org.
University Hospitals is the only program offering the cardiac CT for coronary artery calcium scoring at no cost. The procedure is performed without intravenous lines or contrast agents. The appointment takes about 20 to 30 minutes total, with the actual scan about five to 10 minutes of that time.
Who should be referred for this test?
All men and women age 45 and older with one or more of the following risk enhancing factors:
Risk Enhancing Factors
- Race and Genetics
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- Family history of premature ASCVD (males age <55 years; females age < 65 years)
- South Asian ethnicity
- Female Conditions
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- Preeclampsia
- premature menopause (age < 40 years)
- Lipids
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- Primary Hypercholesterolemia (LDL-C 160–189 mg/dL, non-HDL-C 190–219 mg/dL)
- Persistently elevated triglycerides (⩾175 mg/dL)
- Concurrent High-Risk Conditions
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- Ankle-Brachial Index <0.9, peripheral arterial bypass/stent/angioplasty, prior ischemic stroke
- Chronic inflammatory conditions (rheumatoid arthritis, lupus, psoriasis, IBD, vasculitis, ankylosing spondylitis, hepatitis C infection, HIV/AIDS, or both HIV/HCV)
- Metabolic syndrome
- Chronic kidney disease (eGFR 15–59 mL/min/1.73m2 with or without albuminuria; not treated with dialysis or kidney transplantation)
- Biomarkers
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- Elevated high-sensitivity C- reactive protein levels (⩾ 2.0 mg/L)
- Elevated lipoprotein(a) levels (⩾50 mg/dL or ⩾125 nmol/L)
- Elevated apolipoprotein B levels (⩾130 mg/dL)
Patient Management Recommendations
For patients with borderline to intermediate risk and CACS > 0
- Consider moderate-high intensity statin with LDL goal <100 mg/dl
- Risk factor modification (BP control, DM treatment, smoking cessation, exercise prescription per guidelines)
- Consider ASA 81 mg daily if no contraindication and high risk (CAC>400) and very low bleeding risk
- Do not recommend routine stress testing based on CAC score
For patients with CACS = 0
Consider repeating cardiac CT for CACS at 5 years if the decision to treat the patient and/or their willingness to take statins or other risk modifier medications remains unclear AND they remain at borderline elevated or intermediate risk.
Additionally, consider a referral for consultation with a UH preventive cardiologist for any patient with:
- Cardiac signs or symptoms regardless of CACS
- Type 2 diabetic with heart or vascular disease, chronic kidney disease or heart failure
- Initiation of injectable (PCSK9, GLP-1 therapies)
- Reluctance to initiating treatments including statins, GLP-1, SGLT-2i
- Statin associated myalgia (SAM)
- Reassessment of cardiovascular risk in patients with zero CACS
Consider a referral for consultation with a UH preventive cardiologist for any patient with:
- Cardiac signs or symptoms regardless of CACS
- Reluctance to initiating treatments including statins, GLP-1, SGLT-2i
- Statin associated myalgia (SAM)
- Zero CACS for reassessment of cardiovascular risk
UH Preventive Cardiology Scheduling: 216-844-5965
Consider a referral for consultation with the Center for Integrated and Novel Approaches in Vascular Metabolic Disease (CINEMA) for any patient with:
- Type 2 diabetes and heart, vascular or chronic kidney disease
- Initiation of injectable (PCSK9, GLP-1 therapies)
UH CINEMA Scheduling: 216-844-1357