Question 57 of 433
Should I have a CT angiogram of my heart arteries, with AI plaque analysis?
The short answer
SOMETIMES. It provides detailed coronary information in selected patients. It has not been proven as a screening test for everyone.
A coronary CT angiogram uses contrast dye and shows both hard and soft plaque, which a calcium score cannot. Software can now measure the amount and type. This matters because, as I tell my patients, zero calcium does not mean zero plaque, especially in younger people and in women.
Where I find it most useful: a strong family history of early heart disease, a very high Lp(a), symptoms that are unclear, or a calcium score that does not fit the rest of the picture. The cost is $400 to $1,500 plus the software fee, with a modest dose of radiation and contrast dye. The trial testing whether scanning people without symptoms prevents heart attacks has not reported yet. Until it does, this is a test for individuals, not for everyone over 40.
“This book is for education. It is not medical advice, and reading it does not make you my patient or create a doctor-patient relationship.” From the book’s medical disclaimer. Full disclaimer
ROBUST for indicated chest-pain assessment; NOT DEMONSTRATED for universal asymptomatic CCTA screening benefit.Evidence grade (draft mapping)FNot demonstrated / insufficientARobust human trialsPart 5, Q57 · Part sources
From Longevity Unmasked by Afshine Ash Emrani, MD, FACC. Medical disclaimer. This book is for education. It is not medical advice, and reading it does not make you my patient or create a doctor-patient relationship. Nothing here is meant to diagnose, treat, cure, or prevent any disease. Medicine is personal: a test, drug, supplement, or exercise plan that helps one person can harm another. Do not start, stop, or change any medication or treatment because of something you read in these pages. Talk with a licensed clinician who knows your history first. If you think you are having a medical emergency, call 911. The author disclaims responsibility for any loss or harm arising from use of the information in this book.