At the present time, the American Heart Association and American College of Cardiology do not recommend treatment for people with elevated coronary artery calcification (CAC) scores who do not have other signs and symptoms of coronary artery disease. Additionally, studies have not shown that drug therapy (primarily with statins) has been able to lower CAC scores. Similarly, an elevated CAC score is usually not enough to warrant a coronary angiogram among people who do not have additional signs and symptoms of heart disease.

While researchers work to find the most effective way to incorporate CAC scores into clinical practice, however, people who are worried about atherosclerosis and heart attack can take a number of steps to reduce their overall risk. These include:

Catheter interventions may also be used to treat atherosclerosis, whether or not calcification is present. These procedures use a thin tube (catheter) that is inserted through an artery (usually the femoral artery in the upper thigh) and up to the coronary arteries. These interventions include:

• A balloon angioplasty uses a catheter with a balloon at the tip that can be inflated to press calcified plaque back against artery walls. This procedure increases the amount of blood that can pass through the vessel. This procedure cannot be performed if there is excessive calcification because of the risk that pieces of calcified plaque will break off and cause a heart attack during or immediately after the procedure.
  
  A procedure called stenting is often performed in conjunction with the angioplasty. In this procedure, a small, tubular metal structure called a stent is implanted in the newly opened artery. The stent acts as a scaffold that stretches and supports the artery walls, permitting blood to flow freely through the previously blocked vessel and preventing the crushed plaque from rupturing.

• An atherectomy involves one of three catheters, all of which destroy calcified plaque by cutting it away. Although rarer, this technique may be more appropriate for highly calcified plaque deposits that are unsuitable for angioplasty. Depending on the technique used, the residue is pulverized so that it flows harmlessly through the bloodstream, is removed as the catheter is withdrawn, or is vacuumed through the catheter and out of the body. This procedure is more likely to be done if there is excessive calcification.

Among patients with more advanced atherosclerotic disease, surgery may be recommended. The surgeries used to treat atherosclerosis include:

• Endarterectomy. Usually performed in the carotid arteries in the neck, this surgery is used to prevent stroke caused when pieces of plaque break off and travel through the bloodstream until they block an artery. During this procedure, the surgeon opens the artery in the neck and strips away the plaque, then recloses the artery.
  
  
  
  
  
• Bypass surgery. Usually performed in the coronary arteries in the heart, this surgery is used to prevent heart attack caused when blood flow is restricted to the heart muscle by arterial plaque. During this procedure, the surgeon uses segments of healthier blood vessels from elsewhere in the body to bypass the hardened, narrowed or obstructed arteries.
  
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An experimental strategy to remove calcified plaque from the body is chelation therapy. This technique involves the administration of a certain chemical into the body in a series of up to 50 injections that can take several months to complete. The chemical is designed to bond with the calcium and other chemicals in plaque, changing them into less harmful forms that can be safely flushed from the body.

There is at the present time no published scientific report demonstrating that chelation therapy reduces coronary calcification. In fact, there have been recent randomized trials that show that chelation therapy provides no benefit in treatment of atherosclerosis. More research is necessary before concluding whether or not this treatment is a safe and effective option in the treatment of calcification.