A coronary artery calcium scan is a 10-minute CT that produces a single number — the Agatston score — measuring calcified plaque burden in the heart's arteries. It is one of the most clinically validated cardiovascular tests we have, costs $100–$200 in most U.S. cities, and is wildly under-ordered. The cardiology community has been clear about its value for two decades. Most primary care physicians do not order it. The members at Wellness Elite Fitness who walk through our intake do — Dr. Chaudhari writes the order during the first visit for any member 40+ with a risk factor.
What it measures, mechanically
A non-contrast CT scan of the heart, with the radiation dose of about a single chest X-ray. The scanner detects calcium deposits in the walls of the coronary arteries. Calcium accumulates as atherosclerotic plaque ages — soft plaque first, then calcifies over years. The Agatston score quantifies the volume and density of calcified plaque. A score of zero means no calcified plaque is detected; a score above 100 means meaningful disease; above 400 is severe.
Score-by-age framework
| Score | Read | Action |
|---|---|---|
| 0 | Excellent. Negative predictive value >95% for 10-year cardiac events. | Lifestyle maintenance. Re-scan in 5 years. |
| 1–10 | Minimal disease. Below the median for age. | Tighten ApoB target. Re-scan in 3–5 years. |
| 11–100 | Mild plaque burden. Disease present. | Statin conversation. Aggressive ApoB lowering. |
| 101–400 | Moderate-to-severe burden. Elevated 10-year event risk. | Cardiology referral. Likely statin + lifestyle aggressive. |
| > 400 | Severe. High 10-year event risk regardless of other factors. | Cardiology, statin, and conversation about ezetimibe / PCSK9 if needed. |
The single most-defensible interpretation: a score of zero in a 50-year-old is the strongest non-genetic predictor of cardiovascular health over the next decade we can produce non-invasively. A score above 100 at the same age means the trajectory is already in motion and warrants action.
What it does not measure
CAC quantifies calcified plaque. Soft, non-calcified plaque does not show. A 35-year-old with rapidly progressing soft plaque can have a CAC of zero. This is why CAC is most useful starting in the 40+ age range, where calcification has had time to develop, and why ApoB testing pairs naturally with CAC for a complete picture.
FAQ
What is a coronary artery calcium score?
A non-invasive CT scan that quantifies calcified plaque in the coronary arteries on the Agatston scale (0 = no detectable calcium, 1000+ = severe burden). One of the strongest predictors of cardiovascular mortality over 10–15 years.
What is a good CAC score by age?
Zero is reassuring at any age. Above 100 at 50 warrants serious cardiovascular conversation. The MESA risk calculator translates score, age, and risk factors into 10-year mortality estimates.
When should you get a CAC scan?
Between ages 40 and 55 for adults with any cardiovascular risk factor. Earlier (35–40) with strong family history. Repeat every 5 years if score zero; sooner if elevated.
Where can I get a CAC scan in Houston?
Most imaging centers in Houston offer self-pay CAC scans for $100–$200. Wellness Elite Fitness in Friendswood coordinates the order, interprets the result, and integrates it into the member's longevity protocol. Book a private tour.
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