Coronary Calcium Score (CAC)

Non-contrast cardiac CT to quantify coronary artery calcification and stratify 10-year cardiovascular risk using the Agatston scoring method. Fast, no contrast, no referral needed. Estimated price: €150–180.

The coronary artery calcium (CAC) score at Na Homolce Hospital uses a dedicated non-contrast cardiac CT protocol on the hospital's dual-source Siemens Somatom Flash to quantify calcified plaque in the coronary arteries. The Agatston scoring method assigns a standardised numerical value to the total calcium burden — a score of zero indicates no detectable coronary calcification and a very low 10-year risk of major cardiovascular events, while scores above 400 reflect extensive plaque and substantially elevated risk. The examination takes only 5–10 minutes in the scanner. No intravenous contrast agent is administered, making it safe for patients with renal impairment and those with iodinated contrast allergy who cannot undergo CT angiography. ECG gating synchronises acquisition with the cardiac cycle to minimise motion artefact around the coronary arteries. The SAPHIRE low-dose reconstruction technology used on the hospital's Somatom Flash further reduces radiation exposure during this already low-dose examination. The coronary calcium score is particularly valuable for patients in intermediate cardiovascular risk categories — those where standard risk calculators based on age, cholesterol, blood pressure, and smoking history leave genuine clinical uncertainty about whether to initiate statin therapy or aspirin prophylaxis. A measured calcium score provides direct evidence of whether arterial disease has actually developed, rather than inferring risk from population statistics alone. European Society of Cardiology preventive guidelines support CAC scoring as an optional test to reclassify intermediate-risk patients and inform treatment decisions. A zero CAC score — common in asymptomatic individuals under 60 without multiple risk factors — effectively rules out significant atherosclerotic disease and allows deferral of pharmaceutical intervention, with focus redirected to lifestyle modification. Conversely, a CAC score above 100 justifies more intensive preventive treatment and closer follow-up regardless of the traditional risk factor calculation result. Na Homolce Hospital's Foreign Patients department ([email protected]) handles international self-pay appointments and provides results in English. The examination requires no special preparation beyond avoiding caffeine and heavy meals in the hours before the scan. The written report includes the total Agatston score and per-vessel breakdown (left main, LAD, LCx, RCA), together with clinical interpretation placing the result in context of cardiovascular risk percentiles for the patient's age and sex. The CAC score is often used as a first-step cardiac screening tool, with coronary CT angiography available as a follow-up investigation for patients whose score or symptoms indicate a need for anatomical coronary assessment.