Heart HealthJune 29, 2026·4 min read
By the CIRRUS Editorial Team — how we write and source this
Coronary calcium scoring: when a CT scan tells you more than a cholesterol test
A CAC score directly visualizes plaque rather than inferring risk from blood markers — here's who it's most useful for.
A coronary artery calcium (CAC) scan is a low-dose CT scan that directly measures calcified plaque in the coronary arteries, producing an Agatston score that correlates strongly with cardiovascular event risk — a direct anatomical measurement rather than the risk-factor-based estimation that a standard cholesterol panel and risk calculator provide. A score of zero is associated with a notably low near-term cardiovascular event risk even in people with elevated cholesterol, which can meaningfully change a statin-initiation conversation.
It's most useful for people in an intermediate risk category — where standard risk calculators don't clearly indicate 'start a statin' or 'don't,' and where a direct anatomical answer can break the tie. For people already at clearly high risk (established heart disease, diabetes with other risk factors) or clearly low risk, a CAC score adds less incremental information.
The scan does have a real limitation: it detects calcified plaque specifically, and younger patients or those with unstable, non-calcified plaque can have a low score despite meaningful disease — CAC scoring is generally most informative for adults over roughly 40, and it's typically not covered by insurance as a screening test, running as an out-of-pocket cost in most cases.
This article is general health information, not medical advice, and doesn’t replace evaluation by your own physician. Talk to a doctor about anything specific to your own diagnosis or treatment.