Coronary Calcium Score (CAC)

Non-contrast cardiac CT measuring calcified plaque burden in the coronary arteries using the Agatston scoring method. Fast, radiation-efficient, no contrast required. Starting from €200.

The coronary artery calcium (CAC) score at Agram Hospital is a focused, non-contrast CT examination of the heart that directly quantifies calcified atherosclerotic plaque. The Siemens SOMATOM Force acquires ECG-gated images in a single breath-hold at very low radiation dose; dedicated software then measures the calcium content in each coronary artery and sums these to produce the Agatston score — the most widely validated cardiovascular risk stratification metric derived from CT imaging. A CAC score of zero indicates no detectable coronary calcification. In asymptomatic individuals, a zero score is associated with a 10-year major cardiovascular event rate below 2%, providing strong reassurance and often permitting deferral of statin therapy in patients at intermediate risk by conventional scoring. Conversely, scores above 400 reflect extensive disease with substantially elevated event rates, prompting more aggressive preventive treatment regardless of other risk factor levels. The test is particularly valuable for the 'intermediate risk' patient — someone whose conventional risk factor profile (age, sex, cholesterol, blood pressure, smoking, diabetes) places them in a grey zone between clear benefit from preventive medication and clear deferral. The CAC score moves these patients out of uncertainty: it provides a direct measure of how much subclinical atherosclerosis has already developed, independently of risk factors. Several major guidelines, including the 2021 European Society of Cardiology prevention guidelines, recommend CAC scoring as an optional risk modifier in this population. The examination requires no contrast agent, no special preparation beyond avoiding caffeine for a few hours before the scan, and carries minimal radiation exposure — roughly equivalent to a chest X-ray series. Total time from arrival to departure is approximately 20–30 minutes. Results are reported by Agram's cardiovascular-trained radiologists and typically available within a few working days. The calcium score can also serve as a gateway investigation: patients with elevated scores may be advised to proceed to coronary CT angiography (also available at Agram from €600) to assess whether the calcified plaques are accompanied by significant luminal stenosis. Agram Hospital's deep experience in cardiac CT — the result of over 6,000 coronarography examinations since introducing the technique to Croatia — means the calcium score is interpreted in the context of a fully equipped cardiac imaging centre with subspecialty expertise. Self-referral is accepted for preventive cardiac testing.