Calcium
Score

Diagnosis

Clinical Interpretation

Gender and Age Issues

Recommended Clinical Action

0

No identifiable atherosclerotic plaque

Negative value predictability
90-95% for absence of "significant" CAD

Applicable to men and women over 40, but with caution in younger subjects

Reassure patient while discussing public health guidelines for primary CVD prevention

1-10

Minimal plaque burden
Low CVD risk

Significant CAD unlikely

Applicable to men and women over 40, but note general recommendation*

Discuss general public health guidelines for primary CVD prevention

11-100

Mild plaque burden Moderate CVD risk

Likely mild or minimal coronary stenosis

Greater clinical significance when score is above 75th percentile for age and sex, or if calcium present in 2 or more vessels

Counselling and risk factor modification are indicated. Following NCEP guidelines for cholesterol lowering

101-400

Moderate plaque burden High CVD risk

Moderate non-obstructive CAD highly likely

Greater clinical significance when score is above 75th percentile for age and sex, or if calcium present in 2 or more vessels

Institute risk factor modification and clinical follow-up. Ensure strict adherence to NCEP cholesterol-lowering guidelines. Recommend an appropriate exercise program

Over 400

Extensive plaque burden Very high CVD risk

High likelihood of at least one "significant" coronary stenosis (> 50% diameter)

Greater clinical significance when score is above 75th percentile for age and sex, or if calcium present in 2 or more vessels

Very aggressive risk factor modification using NCEP guidelines as for established CAD. Consider invasive stress test to rule out ischemia

* Presence of chest pain, or multiple risk factors, or younger age subjects or female gender (esp. pre- menopausal) should encourage a more aggressive approach to the therapy/management of the patient.