Coronary Artery Calcium (CAC) Scoring

Coronary artery calcium scoring detects atherosclerosis years before it causes symptoms. A simple, non-contrast CT scan quantifies calcium deposits in the coronary arteries. The resulting score predicts heart attack risk more accurately than traditional risk calculators alone. Yet most people have never heard of it, and most insurance plans refuse to cover it.

The CAC scan occupies an unusual position in cardiovascular medicine. Decades of evidence support its predictive value. The test costs less than many routine procedures. It exposes patients to less radiation than a mammogram. Still, it remains underutilized, largely because economics rather than clinical evidence drive its adoption. Understanding how to access CAC scoring requires navigating a healthcare system where the incentives often work against prevention.

The articles below provide everything you need to understand what CAC measures, how to interpret your results, who should consider testing, and how to obtain a scan if your doctor does not suggest one. The goal is to equip you with the information necessary to make informed decisions about your own cardiovascular health.

CAC Articles

Understanding CAC

• What Is a CAC Scan and How Does It Work? Learn what coronary calcium scoring measures, how the Agatston method works, and what the patient experience involves.
• Scanner Technology and Technical Precision. Understand CT scanner specifications, interscan variability, Agatston score accuracy, and radiation exposure considerations.
• How to Interpret Your CAC Score. Understand what different score ranges mean, how percentiles adjust for age and sex, and why a zero score does not guarantee the absence of disease.

Comparing Tests

• CAC vs Other Cardiac Tests. Compare CAC to CT angiography, stress testing, traditional risk calculators, and biomarkers. Learn when each test adds value.

Guidelines and Indications

• Who Should Get a CAC Scan? Review current guidelines, understand who benefits most, and learn why screening recommendations vary between countries.

Monitoring Over Time

• Serial Testing and CAC Progression. Explore how calcium scores change over time, what progression means clinically, and whether repeat testing adds value.

Limitations

• Limitations and Controversies of CAC Scoring. Understand the blind spots of CAC, including why statins can increase scores while reducing risk.

History

• History and Evolution of CAC Scoring. Learn how CAC emerged as a risk stratification tool, from the Agatston method to the MESA study.

Treatment Decisions

• What to Do With Your CAC Results. Translate your score into treatment decisions, from statin therapy to lifestyle interventions.

Economics and Access

• CAC Costs, Insurance, and Access. Navigate the financial landscape of CAC, from out-of-pocket costs to the reasons insurers decline coverage.

Self-Advocacy

• How to Get a CAC Scan If Your Doctor Doesn’t Suggest One. Get practical guidance on requesting a scan, finding direct-to-consumer options, and discussing results with your physician.

Comprehensive Assessment

• CAC in the Broader Diagnostic Picture. Understand how CAC fits with genetic testing, advanced lipid panels, and other imaging to create a complete cardiovascular risk profile.

Research Gaps

• Research Gaps and Underfunded Questions. Examine what remains unknown about CAC and why certain questions receive less research attention.

Alternative Perspectives

• Alternative and Integrative Perspectives on CAC. Evaluate claims about supplements and lifestyle approaches to arterial calcification, with appropriate caution about evidence quality.