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Updated: Dec 13, 2025

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Coronary artery calcium in primary prevention
Alexander Chua1, Ron Blankstein2, Brian Ko3
1MBBS (Hons).
Insights
Coronary artery calcium scoring identifies asymptomatic individuals at high cardiovascular risk. This non-contrast computed tomography method improves risk stratification and guides preventive treatments like statin therapy.
Area of Science:
- Cardiology
- Radiology
- Preventive Medicine
Background:
- Cardiovascular disease prevention relies on identifying high-risk asymptomatic individuals.
- Coronary artery calcium (CAC) is a specific atherosclerosis marker quantified by non-contrast computed tomography.
- CAC scoring enhances current cardiovascular risk stratification methods.
Purpose of the Study:
- To provide an overview of CAC scoring.
- To detail CAC scoring acquisition, indications, interpretation, and prognostic role.
Main Methods:
- Non-contrast computed tomography for CAC quantification.
- Calculation of the calcium score.
Main Results:
- CAC scoring predicts future cardiovascular risk in diverse asymptomatic populations.
- CAC scoring is most beneficial for intermediate Framingham risk individuals.
- CAC scoring informs decisions regarding preventive pharmacotherapy and statin therapy.
Conclusions:
- CAC scoring is a valuable tool for cardiovascular risk assessment in asymptomatic individuals.
- Repeat CAC scoring can reassess risk, particularly when statin therapy is deferred.
- CAC scoring aids in personalized preventive cardiovascular strategies.
Background:
Identifying high-risk asymptomatic individuals remains the cornerstone of cardiovascular disease prevention. Coronary artery calcium is a highly specific marker of atherosclerosis that can be quantified using non-contrast computed tomography. The resulting calcium score has the capacity to improve current methods of risk stratification.
Objective:
The aim of this article is to provide an overview of calcium scoring, including its method of acquisition, indications, interpretation and role in prognostication.
Discussion:
Calcium score has been shown to convincingly predict future cardiovascular risk in the asymptomatic population across a wide range of ethnicities, ages and sexes. Individuals at intermediate Framingham risk benefit the most from calcium scoring, which can be used to inform the need for preventive pharmacotherapy. Calcium scoring can be repeated after five years to reassess cardiovascular risk, especially when there is a decision to defer statin therapy on the basis of absence of coronary calcium.
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