What Does a CAC Score of 117 Mean?
A CAC score of 117 places you in the moderate atherosclerotic burden category (CAC 100-400) and mandates initiation of statin therapy according to major global guidelines. 1
Risk Category and Interpretation
Your score of 117 indicates:
- Moderate coronary artery calcification - You have detectable atherosclerotic plaque burden in your coronary arteries 2
- Intermediate to moderately-high cardiovascular risk - Approximately 10-20% 10-year risk of cardiovascular events 3
- Definite presence of coronary atherosclerosis - The calcium represents approximately 20% of your total atherosclerotic burden; not all plaques contain calcium 2
What You Must Do: Treatment Recommendations
Statin therapy should be initiated - All major guidelines (ACC/AHA, ESC/EAS, CCS, CSANZ) agree that CAC ≥100 requires statin therapy 1, 2. This is non-negotiable based on your score.
Additional Considerations:
- Aspirin 81 mg daily may be considered, though evidence is more robust for CAC >100 in specialty guidelines 1
- Aggressive lifestyle modification is essential - diet, exercise, smoking cessation if applicable 2
- Optimal blood pressure control and management of all cardiovascular risk factors 2
Clinical Context: Why This Matters
The number needed to treat (NNT) to prevent one cardiovascular event over 5 years with statin therapy is approximately 30 for patients with CAC ≥100 - even in the absence of other lipid abnormalities 2. This means statins are highly effective at your calcium burden level.
Your 10-year cardiovascular event rate is estimated at 10-20%, which is substantially elevated compared to someone with CAC = 0 (who has <1.5-3.0% 10-year risk) 2.
Percentile Ranking
Your score should also be interpreted relative to age, sex, and race-specific percentiles 2, 4. If you fall above the 75th percentile for your demographic group, this further emphasizes the need for aggressive risk factor modification 1.
Important Caveats
- CAC measures atherosclerotic burden, not stenosis severity - Your arteries may maintain normal blood flow through vascular remodeling despite plaque presence 2
- Repeat scanning is not routinely recommended once you have a positive score, though annual increases >15% or >100 units predict higher risk 3
- This is not a "borderline" result - CAC of 117 clearly crosses the threshold (≥100) that triggers definitive treatment recommendations across all major guidelines 1, 2
What Happens Without Treatment
Without intervention, cardiovascular risk increases proportionally with CAC score 2. The presence of calcium indicates you are beyond the primary prevention window where treatment can be deferred - you have established atherosclerotic disease requiring medical therapy.