How we handle coronary calcium scores in Hudson Yards

What a coronary calcium score is

A coronary calcium score is a number derived from a low dose CT scan that measures calcium in the walls of the coronary arteries. We use the score as one piece of your overall heart risk picture, combining it with age, blood pressure, cholesterol, diabetes status and family history to decide next steps.

The test reports an Agatston score, commonly called the coronary artery calcium or CAC score. A higher score means more calcified plaque, which raises the likelihood of coronary artery disease, but the score must be interpreted in context rather than alone.

Who we usually recommend for testing

We order a coronary calcium score when the result will change management. Typical reasons we consider it include:

• People aged 40 to 75 when the risk is uncertain after standard risk calculators.
• Adults with intermediate risk who want more information to guide decisions about preventive medicines.
• People with diabetes, a family history of premature coronary disease, or other risk enhancers where imaging will clarify risk.
• Patients whose cholesterol or blood pressure treatments are being reconsidered and where a score would influence that decision.

Testing is not routine for everyone, and we discuss the value and limits of the scan before ordering it.

How we use the score in your preventive cardiology plan

At The NY Center for the Prevention of Heart Disease we treat the coronary calcium score as a risk refinement tool. We never use it in isolation. Our typical approach follows clear steps.

1. Gather context. We review your history, risk factors, prior tests and current medications.
2. Obtain or review the CT result. We look at the Agatston score and the distribution of calcium.
3. Frame the result for the patient. We explain what the number means for near term and long term risk, and how it changes absolute risk compared with clinical calculators alone.
4. Decide next steps. For modest scores we emphasize lifestyle change and monitoring. For higher scores we discuss intensifying risk factor control, which can include cholesterol management or blood pressure changes. Sometimes we recommend additional imaging, for example a coronary CT angiogram, to look at the arteries more closely to learn more about coronary CT angiogram.
5. Plan follow up. We set a monitoring schedule and document the plan so your primary care doctor and other specialists are aligned.

Our goal is measurable risk reduction, not just a number. Dr. Bradley Radwaner leads this process, personalizing recommendations for each patient.

Common score ranges and what they typically mean

Clinicians often use ranges to summarize risk, while remembering that interpretation depends on age and other risk factors. A typical framework looks like this:

• Score of 0: no detectable calcified plaque, lower near term risk. We may favor lifestyle measures and monitoring.
• Score 1 to 99: small amount of calcified plaque, usually managed with lifestyle change and risk factor control, sometimes with medication depending on overall risk.
• Score 100 to 399: moderate plaque burden. We usually recommend more aggressive risk factor management and consider medication intensification.
• Score 400 or above: higher plaque burden, often prompting a focused prevention plan and consideration of additional testing.

These ranges are a clinical guide. We place your score against your personal risk profile before suggesting changes in therapy.

What to expect during the test

The coronary calcium scan is quick and requires little preparation.

After the scan we review the images, calculate the Agatston score, and discuss results with you at a follow up visit or phone review.

Practical tips on timing and follow up

We will recommend when to repeat testing based on your initial score and risk changes. Common considerations include:

• Repeat testing is rarely needed within a short interval unless clinical status changes.
• If you start or change preventive medications, we track risk through clinical markers rather than frequent repeat scans.
• For people with a rising risk profile or new symptoms, we may move to more detailed imaging or functional testing.

How this fits into our preventive cardiology services

We use coronary calcium scoring as part of a broader preventive cardiology strategy that includes cholesterol management, blood pressure control, and lifestyle counseling. If the score suggests higher risk, we coordinate care with your primary care doctor and other specialists and may recommend targeted treatments available through our preventive cardiology program to learn about our preventive cardiology services. We also draw on advanced imaging information found in resources about cardiac imaging to learn about cardiac imaging when needed.

We provide care to adults across the New York metropolitan area, including patients who live or work near Hudson Yards and throughout Manhattan to learn about our New York location.