What if your heart scan score is ZERO?
Tremendous confusion persists
about the implications about a heart scan score of zero.
A zero score is great! In fact, it’s the best result obtainable. But
does it allow you to do anything you want, free of danger for the
rest of your life?
A zero score can mean many different things
A score of zero is not a rare thing: Approximately 50%
of people who get a CT heart scan have a score of zero—no detectable
calcified coronary plaque. It’s the best score you can get, since heart
scan scores never go below zero. By age 65, only 25% of people will
maintain a score of zero.
But what exactly does a zero score mean? How long does it remain at
zero? What implications does a zero score carry for cholesterol and
other sources of heart disease risk?
Here’s what we know. If you are without symptoms of heart disease and
your CT heart scan score is zero:
- Your risk for heart attack is very low, though not zero. Across all studies, if your score is zero, the likelihood of heart attack (or other major “event”) is in the range of 2-3% over the next 5 years, as compared, for instance, with a score of 100 in a 52-year woman carrying a risk of 20% over the same time period. Why isn’t your risk zero with a zero score? Well, statistically, nobody’s score is zero. That includes strapping 25-year old athletes and children. The exceptions (people who have heart disease with a zero score) include people who use cocaine or amphetamines, people with exceptionally high LDL cholesterol (“heterozygous hypercholesterolemia” with LDL cholesterols >225 mg/dl), those with severe hypertension, and some other rare disorders. In other words, for the vast majority of people with a zero score, your risk is indeed very low.
- Starting with a score of zero, you are unlikely to convert to a significantly positive heart scan score within the next 3–5 years. Approximately 90% of people with a zero score will remain at zero over that time period. For example, say your score was zero in 2005. In 2008, it’s probably still zero. But if it has turned positive (>0), it will likely be a modest score of only 10, 20, or 30—not 300 or 400. Positive scores are, of course, important for your prevention program, but they are rarely dangerous at a level of 10,20, or 30. This is the rationale behind recommending a heart scan score in 3–5 years if you have a zero starting score.
What a zero score does not mean
While a zero heart scan score is great short-term news, it does not mean
that you are free of risk for a lifetime.
A heart scan score of zero does not mean that:
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