What it shows
Evidence and amount of calcified coronary plaque. Higher scores generally indicate a greater burden of atherosclerosis.
SIMONMED LONGEVITY · HEALTHCHECK 2.6
Coronary calcium score
A useful score.
Part of the picture.
A quick, non-contrast CT measures calcified plaque in the heart’s arteries. It can refine a prevention conversation, but it does not show all coronary plaque.
BUNDLED ADD-ON RATE$75with your $399 HealthCheck 2.0
WHAT THE SCORE MEANS
A number that can
add useful context.
A coronary artery calcium scan, often called CAC, measures calcium in coronary artery plaque. The result is usually reported as an Agatston score and interpreted with age and other risk factors. In selected people, it can help clarify prevention decisions when estimated risk alone leaves uncertainty.[1]
What it does not show
The full amount of non-calcified plaque, detailed arterial narrowing or whether a particular plaque will cause a future event.
What makes it useful
A relatively simple test without an IV contrast injection, used to inform a broader conversation about cardiovascular prevention.
THE LIMIT OF ZERO
Zero calcium does not mean
zero plaque.
Plaque can develop before it calcifies. Non-calcified plaque is particularly relevant earlier in the disease process, including in younger adults. A calcium-only test can therefore look reassuring while coronary atherosclerosis is still present.
In a SCOT-HEART analysis of patients with suspected angina, 14% of those with a calcium score of zero had non-obstructive disease on coronary CT angiography and 2% had obstructive disease. These were symptomatic patients; the percentages should not be applied to all healthy adults.[2]
CALCIUM IS ONE COMPONENTSome plaque is visible
Some plaque is visible
before calcium is.
“Soft” commonly refers to non-calcified plaque. Lipid-rich plaque can rupture and trigger a clot, but not all non-calcified plaque is unstable or destined to cause a heart attack.
REACT · 2026
Atherosclerosis can
begin before symptoms.
16,808Adults aged 18–70 without known cardiovascular disease
57.1%Had plaque in at least one of the studied arterial territories
The REACT study used coronary CT angiography and carotid/femoral ultrasound to examine silent atherosclerosis across adult life. Plaque was present even in some young adults, with prevalence rising substantially with age.[3]
The 57.1% figure includes coronary, carotid or femoral plaque; it is not the percentage with coronary disease alone. This was an observational study of disease prevalence, not proof that scanning every asymptomatic adult prevents heart attacks.[3]
CHOOSING A HEART EXAM
Calcium score or CCTA?
Start with the question.
HEALTHCHECK 2.6 · $75
Coronary calcium score
Measures calcified plaque. No IV contrast. A focused risk-refinement tool for selected people.
HEALTHCHECK 2.7 · $749
CCTA + AI plaque analysis
Evaluates the artery lumen and both calcified and non-calcified plaque. Requires IV iodinated contrast and additional preparation.
Explore CCTA ↗Both use ionizing radiation. The choice depends on symptoms, risk, prior testing and the clinical decision to be made. A zero calcium score should not dismiss new symptoms or override an appropriate evaluation.
YOUR EXAM
Advanced Testing.
Results. Plan.
Before
Discuss whether CAC will help a specific prevention decision. Tell the team about pregnancy or possible pregnancy.
During
Lie on the CT table and follow a brief breath-hold instruction. The calcium scan does not require IV contrast.
After
Review the score with your clinician in the context of blood pressure, lipids, diabetes, smoking and family history.
GOOD TO KNOW
Your questions,
answered.
Is a score of zero still good news?
It is generally reassuring for near-term coronary risk in an appropriate screening setting, but it is not a guarantee and does not rule out non-calcified plaque.
Does the score measure a blockage?
No. It measures calcified plaque burden. It does not directly show the percentage narrowing in an artery.
Should I order both CAC and CCTA?
Not automatically. Your team can explain whether a planned CCTA protocol already includes calcium assessment and whether separate testing would add value.
GO FURTHER, THOUGHTFULLY
Connect the right tests.
CONCIERGE SIMONMED LONGEVITY SCHEDULING
Make it part
of your conversation.
xxx xxx xxxx
Locations nationwide · Exam availability varies by location.
HealthCheck 2.6 · $75
Bundled with your $399 HealthCheck 2.0. Add-ons require clinical suitability and may need more time or a separate appointment.
Plan your visit ↗THE EVIDENCE BEHIND THE EXPLANATION
Sources & science.
- SimonMed. Coronary calcium score: exam and role in prevention.
- SCOT-HEART analysis. Coronary calcium, adverse plaque and outcomes, 2021.
- REACT. Prevalence of Silent Atherosclerosis Across Adult Life. New England Journal of Medicine, 2026.
- Low-attenuation non-calcified plaque predicts myocardial infarction: SCOT-HEART. Circulation, 2020.
Sources reviewed September 19, 2026. Study populations and limitations are described above. Educational information complements individualized medical care.