Coronary Calcium Score (CAC)

Non-contrast ECG-gated cardiac CT to quantify coronary artery calcification (Agatston score) and stratify cardiovascular risk. No contrast required. Fast, 10–15 minute appointment. €85. Results with per-vessel score breakdown within working days.

The coronary artery calcium (CAC) score at Alpha Medical quantifies calcified atherosclerotic plaque burden in the coronary arteries using a dedicated non-contrast cardiac CT protocol. ECG gating synchronises the image acquisition to the cardiac cycle, eliminating the motion artefact that would otherwise blur the coronary vessels — the same synchronisation technique used in coronary CT angiography, but without the need for intravenous contrast, beta-blocker preparation, or high heart-rate control in most patients. The Agatston score is the internationally standardised metric for coronary calcium quantification. Each coronary lesion with Hounsfield Units ≥130 (the threshold for calcified plaque) is detected and scored, with the total Agatston score calculated as the sum of individual lesion scores weighted for peak density. The score is then referenced against published age- and sex-specific percentile tables to place an individual patient's result in the context of their demographic peers — a zero score in a 60-year-old man carries different implications than in a 45-year-old woman, and the percentile contextualises this. A zero CAC score is one of the most powerful negative predictors of cardiovascular events in clinical medicine: in multiple large prospective cohorts, the 10-year event rate in patients with a zero score is comparable to that of very low-risk populations, supporting a strategy of reassurance and lifestyle optimisation over pharmacological intervention. At the other extreme, scores above 400 reflect extensive coronary calcification and meaningfully elevated short-term risk, supporting intensified medical therapy and specialist review. European Society of Cardiology guidelines on cardiovascular disease prevention designate CAC scoring as an optional test for reclassification of patients in intermediate-risk categories where the decision to initiate statin therapy or aspirin is uncertain after standard risk assessment (SCORE2, Framingham). A zero score in an intermediate-risk patient supports deferral of pharmacological primary prevention with reassurance; a high score in the same patient provides evidence to initiate therapy. The examination is similarly valuable for patients motivated to understand their cardiovascular health who want objective, quantitative data beyond blood lipids. The examination requires no oral preparation, no intravenous contrast, and takes 10–15 minutes from arrival to completion. ECG electrodes are placed for gating and the scan itself lasts only a few seconds of breath-hold. Alpha Medical's radiologist report provides the total Agatston score, per-vessel breakdown across all four main coronary territories (left main, left anterior descending, left circumflex, right coronary artery), the cardiovascular risk percentile interpretation, and clinical context for the referring physician or the self-referred patient. CD image copies are provided with the written report.