Recent medical studies reveal that popular heart health screenings like coronary artery calcium scans and routine mammogram breast calcification checks may offer limited value for many patients, while a newer blood test called apoB outperforms traditional cholesterol panels in predicting cardiovascular risk.
Routine medical screenings form the backbone of modern preventive medicine, yet recent research demonstrates that some of our most trusted diagnostic tools require a thorough reassessment. From heart scan limitations to overlooked breast calcifications and advanced blood tests, medical experts are rethinking how clinicians identify cardiovascular risk before a heart attack or stroke occurs.
Coronary Artery Calcium and Overall Health Mortality Risks
To combat this, doctors frequently order computed tomography scans to check for calcium buildup in the arteries feeding the heart. However, a massive study presented at the American Heart Association Scientific Sessions 2025 in New Orleans highlights that a coronary artery calcium score tells a much broader story than previously understood.
Researchers at Intermountain Health in Salt Lake City examined the medical records of 40,018 patients who underwent PET/CT stress tests after their doctors determined they were at risk for heart disease. Among those patients, 7,967 had a calcium score of zero, while 32,051 showed varying levels of calcified plaque, as reported by Intermountainhealth. Over a five-year follow-up period, patients with any detectable calcium were two to three times more likely to die from any medical condition compared to those with a zero score.
“Someone’s coronary artery calcium score could be a more powerful predictor of a person’s overall health than we previously thought. We don’t know the mechanism for this extended benefit, but coronary plaque may be correlated with plaque in blood vessels in other parts of the body, and having atherosclerosis may also negatively impact immune surveillance, an important protective mechanism against cancer.”
Jeffrey L. Anderson, MD, distinguished clinical and research physician at Intermountain Health
Perhaps most surprising to the research team, only about a quarter of the patients with calcium who died did so from cardiovascular disease. The majority succumbed to non-cardiovascular illnesses, pointing to prognostic value that stretches far beyond heart attacks alone.
Mammograms as an Early Warning for Women’s Heart Disease
While cardiac scans evaluate specific coronary vessels, routine diagnostic imaging designed for cancer detection may harbor untapped life-saving data. A study presented at a Radiological Society of North America meeting showed that standard mammograms frequently reveal calcium deposits in the arteries of the breast, a condition known as breast arterial calcification, or BAC.
Heart disease affects more than 60 million U.S. women—roughly 44% of the female population—and caused nearly 305,000 deaths in 2023, per data from the U.S. BAC appears in an estimated 15% to 25% of screening mammograms, yet radiologists do not routinely report it.
In a Penn State study analyzing 10,348 women with an average of 4.1 years between scans, researchers utilized an artificial intelligence tool to track vascular calcification severity. Women with worsening calcium buildup faced up to double the risk of major cardiovascular events. Furthermore, researchers detected disease progression in as little as one year, illustrating that cardiovascular risk shifts continuously over time.
Outperforming LDL Cholesterol With Apolipoprotein B Testing
Beyond imaging and scans, blood tests used to guide cholesterol-lowering therapies are also undergoing critical evaluation. Millions of Americans routinely measure low-density lipoprotein, or bad cholesterol, to dictate statin use.
Ciaran Kohli-Lynch, assistant professor of preventive medicine in the division of epidemiology at Northwestern University Feinberg School of Medicine, explained that apoB counts the total number of harmful particles circulating in the blood rather than simply measuring cholesterol content. Using a computer simulation model representing 250,000 U.S. adults eligible for statins, the Northwestern scientists demonstrated that apoB-guided care prevents more heart attacks and strokes cost-effectively.
With new guidelines issued earlier this year by the American Heart Association and 10 other medical associations recommending statin therapy at younger ages, accurate risk stratification has become paramount. While clinicians navigate these evolving guidelines, researchers emphasize that patients should consult medical professionals regarding personalized risk assessments rather than relying on isolated screening scores.
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