Coronary artery calcium scoring

Policy context

Cardiac calcium scoring uses a CT to check for the buildup of calcium in plaque on the coronary arteries. This test identifies and quantifies a marker of coronary disease (plaque), believed to detect earlier stage of CAD. Concern about safety, cost, and efficacy regarding calcium scoring for cardiac disease. Concerns that technology is rapidly diffusing, has a radiation risk (especially cumulative), and is costly.

Status: Decision completed

View findings and decision

Coronary artery calcium scoring (CACS) was first reviewed in 2009 as a diagnostic test for detection of coronary artery disease.

  • In 2020, a review of CACS medical literature was conducted to determine if newly available published evidence could change the original coverage determination. The technology was not selected for rereview.

Primary criteria ranking

  • Safety = Medium
  • Efficacy = High
  • Cost = High
Documents (all assessments)

Update literature (2020)

Assessment (2009)

Assessment timeline

  • Draft report published: August 10, 2009
  • Public comment period: August 10 to August 24, 2009
  • Final report published: September 4, 2009
  • HTCC public meeting: November 20, 2009

Background

Cardiac calcium scoring uses a CT to check for the buildup of calcium in plaque on the coronary arteries. This test identifies and quantifies a marker of coronary disease (plaque), believed to detect earlier stage of CAD. Significant questions involve whether early intervention provides better health outcomes or would lead to additional but unnecessary interventions, especially invasive interventions that involve risk of harm: e.g. before disease becomes clinically apparent, is intervention through a combination of noninvasive (lifestyle and medication) or invasive (angiography, stent, CABG) approaches appropriate.