CTcalciumscores

CTcalciumscores are measurements derived from non-contrast computed tomography scans that quantify calcified plaque in the coronary arteries. The most widely used method is the Agatston score, calculated by identifying calcified lesions (density greater than 130 Hounsfield units) and summing, for each lesion, the area times a density factor. The total score is the sum across all coronary arteries.

Interpretation and use: A score of zero indicates no detectable coronary calcification; higher scores indicate increasing atherosclerotic burden and higher risk of future cardiovascular events. Common interpretations use ranges such as 0, 1–99 (low to mild), 100–399 (moderate), and 400+ (extensive), though exact cutoffs vary by guideline. CTcalciumscores are primarily used to refine risk assessment in asymptomatic individuals or those at intermediate risk and may influence preventive decisions, such as lipid-lowering therapy and lifestyle modification. They are not used to diagnose acute coronary syndrome and do not detect non-calcified plaques.

Limitations: The procedure involves ionizing radiation, though the exposure is generally low. It may underestimate risk in younger individuals who have non-calcified plaques, and results can be affected by CT technique and image quality. Therefore, CTcalciumscores should be interpreted in the context of overall risk factors and clinical judgment.

Clinical note: The use of CTcalciumscores varies by country and guideline. They provide prognostic information beyond traditional risk scores but do not replace comprehensive assessment or medical advice.