What is the Calcium Risk Score test and how is it performed?

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Last updated: April 8, 2025View editorial policy

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From the Guidelines

A calcium risk score test, also known as a coronary calcium scan or coronary artery calcium (CAC) score, is a non-invasive imaging test that measures the amount of calcium buildup in the coronary arteries, and it is performed using a specialized CT scanner that takes multiple X-ray images of your heart, with the results reported as a score, and according to the most recent study 1, a CAC score of zero suggests a low risk of heart attack, while scores above 300 indicate significant plaque buildup and higher risk. The test is particularly useful for people with intermediate risk factors for heart disease, as it can help determine if more aggressive preventive measures are needed, such as statin therapy, as recommended by the guidelines 1. Some key points to consider when interpreting the results of a calcium risk score test include:

  • A score of zero means no calcium is detected and suggests a low risk of heart attack
  • Scores above 300 indicate significant plaque buildup and higher risk
  • The test can help determine if more aggressive preventive measures are needed, such as statin therapy
  • The radiation exposure is relatively low compared to other cardiac imaging tests, but it's still important to discuss with your doctor whether this test is appropriate for your specific situation, as noted in the studies 1. During the procedure, you'll lie on a table that slides into a donut-shaped machine, and you'll be asked to hold your breath briefly while the scanner takes pictures of your heart, as described in the study 1. The entire test typically takes about 10-15 minutes, is painless, and requires no special preparation, making it a convenient and relatively non-invasive way to assess your risk of heart disease, as noted in the guidelines 1. It's also important to note that the absence of coronary artery calcium does not rule out noncalcified plaque, and clinical judgment about risk should prevail, as noted in the study 1. Overall, a calcium risk score test can be a useful tool in refining risk assessment for preventive interventions, and it's particularly useful for people with intermediate risk factors for heart disease, as it can help determine if more aggressive preventive measures are needed, as recommended by the guidelines 1.

From the Research

Calcium Risk Score Test

The calcium risk score test, also known as coronary artery calcium (CAC) scanning, is a non-invasive test that measures the amount of calcium in the coronary arteries. This test is used to assess the risk of coronary artery disease (CAD) and atherosclerotic cardiovascular disease (ASCVD) [ 2, 3,4,5 ].

How is it Done

The CAC scan is typically performed using a computed tomography (CT) scanner. The test is quick and painless, and it does not require any injections or invasive procedures 5. The scan measures the amount of calcium in the coronary arteries, which is then used to calculate a calcium score. This score can range from 0 to over 400, with higher scores indicating a greater amount of calcium and a higher risk of CAD and ASCVD 3, 4.

Key Points to Consider

  • The CAC scan is a highly specific marker of coronary atherosclerosis 4, 5
  • The test is useful in guiding clinical decision-making for primary prevention, such as the use of statins and aspirin 2, 4, 5
  • A CAC score of 0 indicates a low risk of CAD and ASCVD, while a high score indicates a higher risk 3, 4
  • The test is cost-effective and can help reduce healthcare spending 5
  • However, the test does involve some radiation exposure, and the decision to perform a CAC scan should be balanced with this risk 6

Uses of the Test

  • To assess the risk of CAD and ASCVD in asymptomatic individuals 2, 3, 4, 5
  • To guide clinical decision-making for primary prevention 2, 4, 5
  • To monitor the progression of CAD and ASCVD over time 3, 4

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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