Coronary calcium score (CCS)

The coronary calcium score is used to risk-stratify patients in regards to the presence of atherosclerotic coronary disease. The scan is quick, no IV access or IV contrast required, and results take only minutes. Calcium can be reliably detected, and the amount of calcium present correlates with the risk for significant angiographic stenosis. Coronary calcium scoring is available at many centers without a physician's order or appointment for a cash fee.

The Agatston score is used to compute a number score. A score of 0 means no calcium was detected. When the score is > 400, there is a 90% chance of an angiographically significant stenosis. 

Coronary calcium scoring may be reasonable, according to the American Heart Association, in asymptomatic individuals at intermediate risk for heart disease. Screening low-risk populations will result in false positives and screening high-risk populations is not recommended since aggressive risk factor reduction should already be taking place in these individuals. Identifying coronary calcium in intermediate-risk populations will allow the clinician to not only educate the patient regarding their risk for cardiovascular disease, but also be more aggressive with using anti-platelet therapy (aspirin) and statin therapy to prevent progression/reduce the risk of myocardial infarction and stroke.