Key Takeaways
- A coronary calcium score measures the amount of calcified plaque in your coronary arteries using a low-dose CT scan without contrast dye
- A score of 0 indicates no detectable calcified plaque and a very low 10-year risk of heart attack
- Scores above 100 indicate moderate plaque buildup that warrants medical attention and lifestyle changes
- Scores above 400 indicate extensive plaque and significantly elevated cardiovascular risk requiring aggressive treatment
- Your percentile rank compared to others of your age and gender provides context more meaningful than the raw score alone
A coronary calcium score test, also called a coronary artery calcium (CAC) scan, is a specialized low-dose CT scan that measures the amount of calcified plaque deposits in the coronary arteries. The resulting calcium score is a numerical value that helps cardiologists assess your risk of coronary artery disease and future heart events. Understanding what your calcium score means is essential for making informed decisions about heart disease prevention and treatment.
This guide explains how the calcium score test works, what each score range indicates about your cardiovascular health, how your score compares to others of your age and gender, and what steps you can take based on your results.
What Does the Calcium Score Test Measure?
The coronary calcium score specifically measures calcified plaque in the walls of the coronary arteries. Coronary arteries are the blood vessels that supply oxygen-rich blood to the heart muscle. Over time, cholesterol, fat, calcium, and other substances can accumulate in these artery walls, forming deposits known as plaque. When plaque becomes calcified (hardened with calcium), it is detectable on a CT scan.
The test uses a low-dose CT scan without contrast dye, making it quick, non-invasive, and well-tolerated. The scanner takes images of the heart in just a few seconds, and specialized software calculates the total amount of calcium across all coronary arteries. The result is expressed as an Agatston score, named after the researcher who developed the scoring method.
It is important to understand that the calcium score measures only calcified plaque. Non-calcified (soft) plaque, which can also cause blockages and heart attacks, is not detected by this test. For a complete assessment of coronary anatomy including soft plaque, a full CT angiogram is required.
Calcium Score Ranges: What Your Number Means
Calcium scores are grouped into well-established ranges that correspond to different levels of coronary artery disease risk. The following table summarizes what each score range typically indicates and the general clinical interpretation.
| Calcium Score | Plaque Level | Coronary Disease Risk | Clinical Interpretation |
|---|---|---|---|
| 0 | No detectable plaque | Very low | No calcified plaque found. Very low risk of heart attack in the next 5-10 years. Continue healthy lifestyle and routine screenings. |
| 1 – 10 | Minimal plaque | Low | Very small amount of plaque detected. Low risk but indicates early atherosclerosis. Lifestyle optimization recommended. |
| 11 – 100 | Mild plaque | Low to moderate | Mild plaque buildup present. Risk is above average. Discuss statin therapy and risk factor modification with your cardiologist. |
| 101 – 400 | Moderate plaque | Moderate to high | Moderate plaque burden. Significant risk of coronary events. Aggressive risk factor management, statin therapy, and possibly further imaging recommended. |
| Over 400 | Extensive plaque | High | Extensive coronary calcification. High risk of significant blockage and cardiac events. Further evaluation with CT angiogram or stress test strongly recommended. Intensive medical therapy required. |
Calcium score interpretation should always be reviewed with your cardiologist in the context of your overall risk profile.
Understanding Your Percentile Rank
While the absolute calcium score number is important, your percentile rank provides equally valuable context. The percentile rank compares your calcium score to other people of the same age, gender, and ethnicity. For example, a calcium score of 50 might be considered relatively high for a 40-year-old woman but below average for a 70-year-old man.
Being above the 75th percentile for your age and gender means your plaque burden is higher than 75% of your peers, which significantly increases your cardiovascular risk regardless of the absolute score. Conversely, being below the 25th percentile is generally reassuring.
Approximate Calcium Score Percentiles by Age and Gender
The following table provides general reference ranges for median (50th percentile) calcium scores by age and gender. These values are based on large population studies and serve as a guide. Your cardiologist will interpret your specific score in the context of your complete risk profile.
| Age Group | Men (50th Percentile) | Women (50th Percentile) |
|---|---|---|
| 40-44 | 1 – 3 | 0 |
| 45-49 | 4 – 15 | 0 – 1 |
| 50-54 | 15 – 50 | 1 – 5 |
| 55-59 | 50 – 120 | 5 – 20 |
| 60-64 | 120 – 250 | 20 – 60 |
| 65-69 | 200 – 400 | 50 – 120 |
| 70-74 | 300 – 500+ | 100 – 200 |
These are approximate median values. Individual variation is significant. Percentile calculators specific to your demographics provide the most accurate comparison.
As the table shows, calcium scores naturally increase with age, and men tend to develop coronary calcification earlier than women. This is why percentile ranking rather than the raw score alone is crucial for risk assessment.
"The calcium score is one of the most powerful tools we have for reclassifying a patient's cardiovascular risk," says Dr. Shahoo Mazhari, Consultant Cardiologist at DCDC. "I have seen patients with textbook-normal cholesterol levels who turned out to have significant coronary calcification. Without the calcium score, they would have had no warning at all."
Who Should Get a Calcium Score Test?
The calcium score test is most valuable for individuals in specific risk categories. It is not recommended as a screening test for everyone, nor is it typically needed for those with very low or very high known risk.
- Adults aged 40-75 with intermediate cardiovascular risk (based on traditional risk factors)
- Individuals with a family history of premature heart disease (father before age 55, mother before age 65)
- People with borderline cholesterol levels where statin therapy is being considered
- Patients whose risk assessment is uncertain and additional information would help guide treatment decisions
- Individuals who want a quantifiable baseline measurement of coronary health for monitoring over time
The test is generally not recommended for young adults with no risk factors, patients with already-diagnosed coronary artery disease, or those who have had previous stenting or bypass surgery (since existing hardware creates artifacts on the scan).
What to Do Based on Your Calcium Score
Your calcium score should guide, not replace, a comprehensive conversation with your cardiologist. Below are general action plans associated with each score range, though your individual treatment plan will depend on your complete health picture.
Score of 0: Maintain and Monitor
A calcium score of zero is very reassuring. It means no calcified plaque was detected and your risk of a heart event in the next 5-10 years is very low. Continue with a heart-healthy diet, regular exercise, and routine checkups. Consider repeating the test in 5-10 years if risk factors are present.
Score of 1-100: Lifestyle Optimization
This range indicates early to mild atherosclerosis. Focus on aggressive lifestyle modifications: maintain a heart-healthy diet, exercise regularly, manage blood pressure, optimize cholesterol levels, and stop smoking if applicable. Your cardiologist may discuss starting statin therapy, particularly if your score is above 50 or your percentile is high.
Score of 101-400: Active Medical Management
Moderate plaque burden requires active management. Statin therapy is typically recommended, along with aggressive control of blood pressure, diabetes, and other risk factors. Your cardiologist may recommend additional testing such as a stress test or CT angiogram to evaluate whether any blockages are causing reduced blood flow to the heart.
Score Over 400: Intensive Evaluation and Treatment
An extensive calcium score demands thorough evaluation. Your cardiologist will likely recommend a full CT angiogram or stress test to assess the degree of coronary blockage. Intensive medical therapy including high-dose statin, antiplatelet medication, and strict risk factor control is standard. In some cases, invasive angiography may be needed to determine whether stent placement or surgery is necessary.
Can You Lower Your Calcium Score?
This is one of the most frequently asked questions. The honest answer is that once calcium deposits form in coronary arteries, they generally do not decrease. A repeat calcium score test will likely show a stable or slightly increasing number even with optimal treatment.
However, this does not mean treatment is ineffective. The goal of medical therapy is not to reduce the calcium score itself, but to stabilize plaque, prevent new plaque formation, reduce inflammation, and lower the risk of plaque rupture (which is what causes heart attacks). Statin therapy, in particular, has been shown to calcify and stabilize soft plaque, which can actually cause the calcium score to increase slightly while significantly reducing heart attack risk.
Lifestyle changes such as regular exercise, a Mediterranean-style diet, smoking cessation, and weight management can slow the progression of coronary calcification and reduce overall cardiovascular risk, even if the calcium score number does not decrease.
Calcium Score vs. CT Angiogram: Different but Complementary
The calcium score test and the CT angiogram are related but different tests. The calcium score is a quick, low-dose scan without contrast that quantifies overall plaque burden. A CT angiogram is a more detailed scan with contrast dye that shows the exact location, degree, and type of plaque in the coronary arteries.
| Feature | Calcium Score Test | CT Angiogram |
|---|---|---|
| Contrast dye | No | Yes |
| Radiation dose | Very low (< 1 mSv) | Low (3-5 mSv) |
| Scan duration | 5-10 minutes | 10-15 minutes |
| What it shows | Total calcified plaque burden (number) | Detailed artery images, blockage location and severity, soft and hard plaque |
| Best for | Risk stratification, screening | Diagnosing specific blockages, planning treatment |
| Cost (approximate AED) | 500 – 1,200 | 2,000 – 4,000 |
Both tests are non-invasive and performed on a CT scanner. Your cardiologist may recommend one or both depending on your clinical needs.
The Calcium Score Test Procedure
The calcium score test is one of the simplest cardiac imaging procedures available. No preparation is required. You do not need to fast, and no contrast dye is injected. You lie on the CT scanner table, and the technologist attaches ECG leads to your chest to synchronize the images with your heartbeat. The scan itself takes only 5-10 seconds of breath-holding. The entire appointment is usually completed in under 15 minutes.
Results are typically available within 24 hours. Your cardiologist will review the score along with your complete medical history, risk factors, and any other test results to provide personalized recommendations.
Calcium Score Testing at DCDC Dubai Healthcare City
At Doctors Clinic Diagnostic Center in Dubai Healthcare City, coronary calcium scoring is performed using advanced CT scanner technology that delivers accurate results with minimal radiation exposure. The center's cardiology and radiology teams work together to ensure each patient receives a thorough interpretation of their results along with actionable health recommendations.
With more than 13 years of operation in Dubai Healthcare City and over 1,000 diagnostic scans performed monthly, DCDC is a leading diagnostic center in Dubai. The center welcomes international patients from around the world alongside UAE residents, providing premier cardiac imaging and preventive cardiology services.
A compelling example of the calcium score's value came from a 45-year-old Dubai resident who had no symptoms and considered himself healthy. His physician suggested a routine calcium score as part of an executive health check at DCDC. The result was a score of 150, placing him well above the 75th percentile for his age group. This unexpected finding prompted early statin therapy and an aggressive lifestyle modification program. "This patient had no chest pain, no shortness of breath, and no family history he was aware of," recalls Dr. Shahoo Mazhari, Consultant Cardiologist at DCDC. "Without the calcium score, we would have had no reason to suspect anything. That single number changed his entire treatment trajectory and potentially saved his life."
DCDC serves patients from across Dubai and the UAE, providing a streamlined experience from booking through results. For patients whose calcium score warrants further evaluation, the center offers seamless progression to CT angiography or cardiology consultation within the same facility.
Book Your Calcium Score Test at DCDC
Take a proactive step for your heart health. At Doctors Clinic Diagnostic Center in Dubai Healthcare City, our cardiology team provides coronary calcium scoring with fast, accurate results and personalized risk assessment. Know your number and protect your heart.
Book Calcium Score TestFrequently Asked Questions
Final Thoughts
Your coronary calcium score provides a direct, quantifiable window into the health of your coronary arteries. Unlike many cardiac risk calculations that rely on indirect factors like cholesterol and blood pressure, the calcium score measures actual plaque in your arteries. A score of 0 offers powerful reassurance, while an elevated score provides the early warning needed to take preventive action before a heart event occurs. At Doctors Clinic Diagnostic Center, our cardiology team uses calcium scoring as part of a comprehensive approach to cardiovascular risk assessment.
If you are over 40 with any cardiovascular risk factors, or if you simply want a clear picture of your coronary health, discussing a calcium score test with your cardiologist is a practical and affordable first step. The knowledge gained from a simple, painless scan can shape years of informed health decisions and give you the confidence that comes from knowing your numbers. If a follow-up CT angiogram is needed, learn about CT angiogram pricing in Dubai.
Sources & References
This article was reviewed by our medical team and references the following sources:
- American Heart Association / American College of Cardiology - CAC Scoring Guidelines
- Society of Cardiovascular Computed Tomography (SCCT) - CAC Expert Consensus
- Multi-Ethnic Study of Atherosclerosis (MESA) - CAC Reference Values
- European Society of Cardiology - Cardiovascular Prevention Guidelines
Medical content on this site is reviewed by DHA-licensed physicians. See our editorial policy for more information.
Written by
Dr. Shahoo Mazhari
Consultant Cardiologist
MD, Board Certified in Cardiology
Dr. Shahoo Mazhari is a Consultant Cardiologist specializing in non-invasive cardiac imaging, coronary CT angiography, and preventive cardiology at DCDC Dubai Healthcare City.