A postcard might have saved Mary Ann Fink’s life.
It was the kind of direct mail that might otherwise have gone straight from mailbox to recycling bin. But what it was promoting that day in May 2015 grabbed Fink’s attention: University Hospitals was offering a coronary calcium scoring test for free during the month of June.
Fink didn’t know anything about the test, but her high blood pressure and family history of heart problems kept her on the alert for information related to coronary health.
“My dad had his first heart attack at 39,” says Fink, 63, of Solon. “He had a stroke at 61 two weeks after getting a heart catheterization. I’m scared to death of ending up having to have a heart cath.”
Typically, doctors estimate a patient’s risk of heart attack, stroke or cardiovascular death through factors such as family history, smoking, high cholesterol and other lifestyle choices.
“Coronary calcium scoring directly measures the degree of the hardening of the arteries,” says Dr. Daniel I. Simon, former president of the Harrington Heart and Vascular Institute and the new president of University Hospitals Case Medical Center. “It’s the most accurate risk predictor we have.”
Done with a simple five-minute CT scan, it reveals how much calcium is accumulating in the walls of a patient’s coronary arteries and assigns a score that translates into a patient’s risk for a cardiac event over the next 10 years. A score below 100 indicates a
3 percent risk, while 100 to 399 means 13 percent. For Fink, the test revealed bad news: With a score of 552, she had a 25 percent risk of heart attack, stroke or cardiovascular death in the next 10 years.
The information prompted her to request a heart flow test — something she also read about in a UH mailing — which provided even more detailed information about her coronary arteries.
“If there was anything I could do to avoid more invasive procedures, I’m there,” Fink says.
While the coronary calcium test isn’t new (UH started offering it in 2007), the $99 exam is typically not covered by insurance. The no-cost offer increased requests for it fourfold. Eight hundred patients took the test in June 2015 and severe disease — a score over 400 — was detected in 15 percent of them. The ratio of women taking the test increased from 40 to 60 percent. After the trial offer, the system is considering making it permanently free.
“This test helps [a physician] drive the intensity of recommendations of what you do for a patient,” says Simon.
In Fink’s case, that meant adjustments to her statin medications, which she had already been taking for a few years, and the addition of daily aspirin. The test results were also added motivation to increase her activity level, improve her diet and reduce her stress.
Despite arthritis in her knees, she’s walking more. She’s also given up soda and is eating more fruits and vegetables. “Now I know where I stand and what I have to do about it,” she says.