Coronary calcium scoring is a non-invasive way to quantify the amount of calcium present in the coronary arteries, offering an estimate of the risk of associated coronary artery disease (CAD). Ultrafast CT scans are used to take images of the coronary arteries with a high degree of sensitivity and reproducibility.

Coronary calcium scoring can determine accurately whether or not CAD is present. The amount of calcium deposits correlates with the amount of calcified plaque present in the arteries.

Early detection of CAD can potentially have significant impact on the disease by encouraging individuals to evaluate possible changes in diet, behavior, or beginning medical therapy if indicated.

The amount of calcium in the coronary arteries can be calculated and represented by different scoring methods.

The Agatston calcium score is determined by the area of calcification per coronary segment and then multiplied by a factor of 1-4 depending on the maximum density of that segment. Based on this scoring method, as score of 0 indicates the absence of calcified plaques and extremely low likelihood of any significant CAD. A score of <10 has been found to have similar clinical significance as a score of zero, but does indicate the presence of some plaque. A score between 10 and 100 indicates a mild plaque burden with a mild risk of future coronary events. A score between 100-400 indicates a moderate risk with a definite risk of future cardiac events and a moderately high chance of significant coronary artery narrowing. A score over 400 indicates significant calcified plaque burden with a high likelihood of extensive coronary artery disease.

Recently, a newer and more reproducible way to calculate your coronary calcium score has been developed and involves determining the volume of calcium present in the coronary arteries. Conversion factors allow for comparison with the older Agatston scores.

The odds ratio of developing symptomatic cardiovascular disease has been reported to be as high as 7:1 in patients with scores >50, 20:1 in patients with scores >100 and 35:1 in those with scores >160. The risk stratification capability of coronary calcium scoring is especially significant when compared to the predictive powers of traditional risk factors in foretelling the development of symptomatic coronary disease: 1.8:1 for total cholesterol >240mg/dl; 1.8:1 for HDL <35; 3.6:1 for cigarette smoking: and 1.2:1 for systolic hypertension.

The clinical significance of a particular score is influenced by the patient's age and gender. A score of 150 may be 'average' for a 70-year-old man, but would be considered markedly abnormal for a 40 year old woman.

Your calcium score is calculated and compared to other men or women of your age and compared to the general population, giving you an idea of your risk for heart disease.