Coronary Artery Calcification Treatment

Coronary arteries are the arteries surrounding your heart. Calcium in the arteries (calcification) indicates a buildup of fatty substances and this can be a sign of heart disease. A build-up of plaque in your arteries causes your arteries to become more narrow, and so it is more difficult for you to pump blood to the heart and body. If you have coronary artery calcification, it is likely you also have atherosclerosis. 

Arterial calcification is identified using a type of CT scan or intravascular ultrasound. There is currently no standardised treatment for coronary artery calcification, but treatment strategies include managing the risk factors of artery calcification, improving your CAC score and sometimes surgery to widen the arteries and allow blood flow to the heart.

Read on to find out more about:

  • What does coronary artery calcification mean?
  • How serious is it?
  • How is coronary artery calcification diagnosed, and what is a CAC score?
  • What are the risk factors?
  • Treatments for coronary artery calcification

About coronary artery calcification

Coronary artery calcification is the process of fatty deposits (known as plaques) building up within the coronary arteries, which are the arteries surrounding the heart. The plaques are made up of calcium and fatty substances such as cholesterol. These plaques can increase in size and begin to make the flow of blood and oxygen to the heart more difficult. If a plaque breaks away from the blood vessel, it can travel in the bloodstream and may block an artery, which can cause dangerous effects such as a heart attack or stroke.1

How serious is it?

The calcium in the arteries represents the build-up of fatty plaques that can increase your risk of cardiovascular events (such as a stroke or heart attack) and atherosclerosis. Atherosclerosis is the hardening and build-up of plaques within the arteries. This ‘hardening’ is the process of calcium build-up in the arteries and blood vessels. 

As the arteries and blood vessels become harder and less flexible, the heart must work harder to effectively pump blood around the body, increasing the risk of heart failure.1 Coronary artery calcification is therefore commonly found in patients with coronary heart disease. This means that coronary artery calcification can be a very serious disease if it is not managed appropriately. However, there are many ways to help prevent coronary artery calcification, which we will also cover in this article.

Causes, symptoms and diagnosis

What are the causes of coronary artery calcification?

It is unclear whether coronary artery calcification has direct causes or only risk factors that increase how likely you are to develop the condition. The most likely cause is atherosclerosis.

Other potential causes of coronary artery calcification include:3,4

  • Obesity
  • Diabetes mellitus
  • Dyslipidemia (unhealthy levels of cholesterol and fat in the bloodstream)
  • Chronic kidney disease

What are the symptoms of coronary artery calcification?

The symptoms of coronary artery calcification are serious. They include

  • Chest pain (known as angina)
  • Numbness of your hands or feet
  • Lowered blood pressure

These side effects are very serious. If you are suffering from these symptoms, it is important to consult with a doctor or a health practitioner.

How is it diagnosed?

If your doctor believes you may have coronary artery calcification, you will be asked to take a scan called an intravascular ultrasound or a CT scan. This scan is done by a radiographer and will give you a CAC score. This scan is able to identify a build-up of calcium at a very early stage. A CAC score of 0 indicates that you have no calcium or fatty plaques in your arteries, which means you are healthy with a decreased risk of heart disease.5

A CAC score above 0 indicates you have calcium in your arteries, and this also means you will have plaque build-ups that can increase your risk of developing atherosclerosis and associated cardiovascular events, including strokes and heart attacks.2

Risk factors

One of the biggest risk factors for coronary artery calcification is high blood pressure.

Other important risk factors include:3,4

  • Obesity
  • Dyslipidemia (unhealthy levels of fat in the blood)
  • Not engaging in physical exercise
  • A family history of coronary artery calcification
  • An unhealthy and unbalanced diet
  • Being over 70 years of age
  • Having high levels of fibrinogen or C-reactive protein in your blood

Treatment

There is no current treatment for coronary artery calcification. However, simple lifestyle changes can be extremely effective in decreasing your CAC score and preventing you from developing coronary artery calcification, which is based around treating the risk factors for coronary artery calcification.4

Below are some of the ways you can manage your risk factors to help prevent yourself from developing coronary artery calcification and potential treatment methods.

Treating your risk factors

The risk factors, as previously mentioned, greatly increase the chances of a high CAC score and developing coronary artery calcification.1

As you get older, it is very important to go to the doctors more regularly and have blood tests and screenings that help your doctor identify cholesterol, high blood pressure, diabetes and your CAC score. Please book an appointment with your GP if you are over the age of 70 and have not had a blood test over the last 2 years, or are experiencing some of the symptoms of arterial calcification.

A high blood pressure

To treat high blood pressure, otherwise known as hypertension, you may be prescribed blood pressure medications. You can read more about this here.

Diet, lifestyle and diabetes 

It can be a good idea to keep fit, and active and eat a balanced diet. This may help decrease the levels of circulating fat and cholesterol and it may also decrease the risk of developing type 2 diabetes which is another important risk factor.

Medications

There has been some research to suggest that calcium channel blockers or medicinal supplements may improve coronary artery calcification, but currently, there is not enough evidence to confirm how effective these medications are. 

Medications that can be used to prevent coronary artery calcification from developing include:6

  • Medications to lower cholesterol such as statins
  • Medications to lower blood pressure, such as beta blockers
  • Anti-diabetic medications such as sulfonylurea medications
  • Medications to thin the blood and prevent a blood clot, such as low dose aspirin
  • Medications that help with blood clots, such as warfarin

Growing evidence supports the use of vitamin K in vascular calcification. This vitamin is important for regulating levels of calcium in the body. There has been some research to show that supplementing vitamin K helps with decreasing arterial stiffness, vascular calcification and coronary artery disease. It may also even decrease the risk of developing type 2 diabetes.7

Surgical methods

Surgical methods do not treat coronary artery calcification specifically but are used in the identification and treatment of heart disease. These methods allow entry into the hardened arteries caused by calcification. This procedure is called cardiac catheterization. It is used to help doctors identify if your arteries and blood vessels are narrowed or blocked. It also helps them plan treatments and surgeries to treat the condition.

After this procedure, you may require surgery to widen your arteries and allow blood to flow more easily to the heart to prevent heart attacks and strokes. 

These surgeries help to remove calcium and plaque build-up. They may include:3

  • Balloon angioplasty. A balloon is used to stretch open the narrow artery
  • ‘Cutting’ and ‘Scoring’ balloons to help ‘cut’ the plaque build-ups
  • Rotational atherectomy. A rotational shaver or laser removes the plaque build-up

When to see a doctor?

There are no early symptoms of coronary artery calcification, so it is difficult to pinpoint when you should reach out to a doctor. What you can do is ensure you are attending your blood pressure and blood test check-ups , and keep your doctor up to date with any changes in symptoms you may have. Not everybody will need a CT calcium score, you should discuss your individual needs with your doctor.5

Summary

The important messages from this article are:

  • Coronary artery calcification is a build-up of calcium and fatty plaques in the heart arteries and this can increase your risk of cardiovascular disease
  • Coronary artery calcification is diagnosed using an x-ray. A CAC score can indicate how much calcium is in your arteries
  • Being overweight, eating unhealthily or having other family members with coronary artery disease can increase your risk of developing it
  • There are no standard treatments for coronary artery calcification currently. Potential treatments include managing your risk factors and surgery

References

  1. British Heart Foundation. What is calcification of the arteries, and how can I treat it? [Internet]; 2021. Available from: https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/ask-the-experts/calcification-of-arteries 
  2. Houston Methodist. Calcium score: What is a cac & do I need one? [Internet]; 2021. Available from: https://www.houstonmethodist.org/blog/articles/2021/oct/calcium-score-what-is-a-cac-test-do-i-need-one/#:~:text=The%20coronary%20artery%20calcium%20
  3. Liu W, Zhang Y, Yu, C, Ji, Q, Cai M, Zhao Y, Zhou Y. Current understanding of coronary artery calcification. J Geriatr Cardiol 2015, 12(6):448-675. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4712374/ 
  4. Mohan J, Bhatti K, Tawney A, Zeltser R. Coronary Artery Calcification. StatPearls [Internet], 2022. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519037/ 
  5. Nuffield Health. CT calcium scoring (or cardiac calcium scoring) [Internet]; undated. Available from: https://www.nuffieldhealth.com/tests-scans/ct-calcium-scoring-or-cardiac-calcium-scoring 
  6. Coronary Calcification Treatment Options [Internet]; undated. Available from: https://www.templehealth.org/services/conditions/coronary-calcification/treatment-options 
  7. Hariri E, Kassis N, Iskander JP, Schurgers LJ, Saad A, Abdelfattah O, Bansal A, Isogai T, Harb SC, Kapadia S. Vitamin K2 - a neglected player in cardiovascular health: a narrative review. Cardiac risk factors and prevention 2021: 8(2). Available from: https://openheart.bmj.com/content/8/2/e001715#block-system-main 
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Laura Preece

BSc Pharmaceutical Sciences and MRes Pharmacy and Pharmaceutical Sciences
I am a researcher and medical writer with a passion for pharmaceutics, disease and biological sciences. I am currently researching cellular and molecular biology, investigating the use of vitamin C as an adjunctive therapy for diabetes mellitus.

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