CT coronary calcium score

CT Coronary Calcium Score: A Guide for Patients

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Heart health is a matter of paramount importance, and advancements in medical technology have given us powerful tools to assess and manage cardiovascular risks. One test that most patients undergo to see if they have ‘blocked arteries’ is a coronary angiogram.

However, not everyone needs this test. Simpler tests are available that can provide similar information. One such test gaining prominence is the CT Coronary Calcium Score.

In this guide, I will discuss what this test entails, who should consider it, and the valuable insights it provides for managing your heart health.


At least 25% of people who had an acute myocardial infarction that did not end in death or sudden death had no past symptoms. Finding people who don’t have any symptoms but are more likely to have a heart attack in the future is a key part of putting preventive measures into action.

What is the CT Coronary Calcium Score?

The CT Coronary Calcium Score is a non-invasive imaging test that measures the amount of calcium deposits in the coronary arteries.

These deposits can indicate the presence of atherosclerosis, a condition characterized by the buildup of plaque in the arteries that can restrict blood flow to the heart.

How is the Test Conducted?

During the test, you will lie on a table that slides into a CT scanner. The scanner captures detailed images of your heart, and a computer calculates the amount of calcium present in the coronary arteries.

The results are then scored to assess the overall risk of coronary artery disease.

Indications for the CT Coronary Calcium Score: Who Should Consider the Test?

The CT Coronary Calcium Score is particularly useful for individuals with intermediate risk of heart disease, as well as those with risk factors such as high blood pressure, high cholesterol, diabetes, or a family history of heart disease.

It is not recommended for everyone, so consulting your doctor to determine if you’re a suitable candidate is crucial.

What Information Does it Provide?

The test results provide a numerical score indicating the amount of calcium in your coronary arteries. This score correlates with the extent of atherosclerosis. Cardiologists use this information to assess your risk of heart disease and tailor preventive measures accordingly.

Understanding Your Results

The scoring system used for the CT Coronary Calcium Score is known as the Agatston Score. Dr. Arthur Agatston created it in the 1990s, and it is now a widely used technique for measuring the amount of calcium in the coronary arteries.

Agatston Score Explained

Identification of Calcium Deposits: During the CT Coronary Calcium Score test, specialized software identifies and quantifies calcium deposits in the coronary arteries.

Density and Area Measurement: The Agatston Score takes into account both the density and area of the calcified plaques. Higher density and a larger area contribute to a higher score.

Scoring Calculation: The score is calculated by multiplying the density of the plaque by the area it occupies in the coronary artery. This results in a numerical value for each identified plaque.

Total Score: The individual scores for all identified plaques are then added together to obtain the total Agatston Score for a particular patient.

Interpretation of Agatston Score

1. Score Categories:

  • 0: No evidence of coronary artery calcium.
  • 1-10: Minimal evidence of calcium.
  • 11-100: Mild evidence of calcium.
  • 101-400: Moderate evidence of calcium.
  • Over 400: Extensive evidence of calcium.

2. Risk Stratification:

  • Low Score (0-10): Low risk of coronary artery disease.
  • Intermediate Score (11-400): Intermediate risk.
  • High Score (Over 400): High risk of coronary artery disease.

How Cardiologists Use the Agatston Score

1. Risk Assessment:

  • A low Agatston Score generally indicates a lower risk of coronary artery disease.
  • A high Agatston Score suggests a higher likelihood of significant atherosclerosis and increased cardiovascular risk.

2. Treatment Decision-Making:

  • Low scores may result in lifestyle modifications and preventive measures.
  • Intermediate to high scores may lead to more aggressive interventions, such as medications or further diagnostic tests.

3. Long-Term Prognosis:

  • The Agatston Score provides prognostic value, helping cardiologists predict the likelihood of future cardiovascular events.

Limitations Of The Agatston Score

While the Agatston Score is a valuable tool, it has some limitations:

  • Limited Information on Plaque Composition: It does not provide information on the composition of the plaque (e.g., whether it’s calcified or non-calcified).
  • Does not Capture Non-Calcified Plaques: The score may not account for non-calcified fatty plaques, which could also contribute to the risk of coronary artery disease.
  • Radiation Exposure: The CT scan involves a low dose of radiation, and its long-term effects should be considered, especially in patients requiring repeated testing.

Despite these limitations, the Agatston Score remains a crucial component in assessing cardiovascular risk and guiding personalized treatment strategies based on the presence and extent of coronary artery calcium.

It is important to discuss the results and their implications with your doctor in order to determine the most appropriate course of action for your individual case.

How Does the CT Coronary Calcium Score Influence Patient Management?

Cardiologists use the CT Coronary Calcium Score to refine risk assessments. If the score is low, it may suggest a lower likelihood of significant coronary artery disease. In contrast, higher scores may prompt more aggressive interventions, such as lifestyle modifications, medications, or further diagnostic tests.

Prognostic Value of the Test

Several studies, including those published in reputable journals like the New England Journal of Medicine, highlight the prognostic value of the CT Coronary Calcium Score. A high score is associated with an increased risk of future cardiovascular events, providing valuable information for long-term management.

Is it Worth Undergoing the Test?

Weighing the Benefits and Risks

The decision to undergo the CT Coronary Calcium Score should be a collaborative one between you and your doctor. Consideration of your overall health, risk factors, and medical history will guide this decision.

While the test can provide valuable insights, it’s not a one-size-fits-all solution, and your healthcare provider will help determine its appropriateness for your individual case.

Frequently Asked Questions

Q: Is the CT Coronary Calcium Score the same as a traditional coronary angiogram?
A: No, they are different. The CT Coronary Calcium Score assesses the presence of calcium deposits in the arteries, while a traditional coronary angiogram involves injecting contrast dye into the arteries to visualize blood flow.

Q: How often should the test be done?
A: The frequency of the test depends on individual risk factors and health status. Your healthcare provider will determine the appropriate interval.

Q: Does a high score mean I have heart disease?
A: A high score indicates an increased risk, but it does not confirm the presence of heart disease. Further evaluation may be needed.

Q: Are there any risks associated with the test?
A: The CT Coronary Calcium Score is generally considered safe. It involves a low dose of radiation, and the benefits usually outweigh the risks for those at risk of heart disease.

Q: Can lifestyle changes reduce the calcium score?
A: Adopting a heart-healthy lifestyle, including a balanced diet, regular exercise, and smoking cessation, can positively impact your cardiovascular health and potentially slow the progression of atherosclerosis.

In conclusion, the CT Coronary Calcium Score is a valuable tool to determine your cardiovascular health. Its non-invasive nature, coupled with the wealth of information it provides, makes it an important consideration for individuals with certain risk factors.

However, each patient is unique, and decisions regarding this test should be made in consultation with a healthcare provider, ensuring personalized and effective heart health management.


The information provided in this article is intended for general informational purposes only and should not be considered as professional medical advice. It is not a substitute for consultation with a qualified healthcare provider. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this article. Reliance on any information provided in this article is solely at your own risk. The author and the platform disclaim any responsibility for any liability, loss, or risk, personal or otherwise, which is incurred as a consequence, directly or indirectly, of the use and application of any information presented herein.

Dr Vivek Baliga B
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