Coronary calcium scans may clarify whether to take a statin.

New cardiology guidelines link coronary artery calcium scan scores to recommended LDL targets, and short CT scans that take under 10 minutes can help clarify risk for some middle-aged adults.

New cardiology guidelines now tie coronary artery calcium (CAC) scan results to recommended LDL levels. CAC scans are quick heart CT tests that take less than 10 minutes and show calcium in coronary arteries as a marker of plaque. The guidance highlights the scan’s role when it is unclear whether a middle-aged person should start cholesterol-lowering medication. The change reflects growing evidence that CAC scores add precision to traditional risk measures. Key facts: - The new guidelines upgraded the use of CAC scans to a top recommendation for cases where medication decisions are uncertain, especially for men over 40 and women over 45. - CAC scores are reported in categories: 0 (no detectable plaque), 1–100 (mild), 100–299 (moderate), 300–1,000 (severe), and over 1,000 (extensive). - The guidelines link CAC categories to LDL targets: under 100 mg/dl for scores below 100; under 70 mg/dl for scores 100–299; under 70 mg/dl with a more ambitious goal under 55 mg/dl for scores ≥300; and under 55 mg/dl for scores over 1,000, as reported in the article. - The scans typically cost about $75–$200 out of pocket, are increasingly covered by insurance, use a small amount of radiation similar to a mammogram, and often do not need frequent repetition. - CAC testing is most useful in people whose 10-year cardiovascular risk falls in a borderline or intermediate range and can influence decisions and patient willingness to begin cholesterol-lowering medication; a score of zero does not eliminate future risk. Summary: The updated guidance formalizes a link between CAC findings and specific LDL goals and raises the role of a brief calcium scan in treatment conversations for middle-aged patients with uncertain need for medication. The change may shift how clinicians assess borderline or intermediate 10-year risk. Undetermined at this time.