Monday, August 24, 2026

Coronary Calcium Score: Now What Do I Do?

You got a number that scared you more than any lab result ever has. Here's what it actually means — and what to do next.

Author Bishnu Subedi, MD, FACC
Category Health / Preventive Cardiology
Read time ~4 minutes
One-line takeaway A calcium score is information, not a verdict — and there's a clear next step for every range.

The Big Idea

Your Coronary Artery Calcium (CAC) score measures hardened plaque in your heart's arteries, not whether you're blocked or in danger today. Written by a board-certified cardiologist, this book turns one confusing number into a clear, evidence-based action plan — covering medications, diet, exercise, and the hidden factors (like vitamin D or thyroid disease) that can skew your score.

Key Takeaways

Concept What It Means Apply It This Week
The Agatston Score The raw number (0 to 1,000+) quantifying calcified plaque in your arteries. Find your score's age/sex percentile, not just the raw number.
Power of Zero A score of 0 predicts very low near-term risk — but isn't a lifetime guarantee. If your score is 0, ask your doctor when to rescan (usually 5–10 years).
Score ≠ Blockage CAC shows plaque presence, not whether an artery is actually narrowed. Don't request a stent or bypass based on CAC alone — ask what test would actually confirm blockage.
Statin Threshold Guidelines favor statin therapy once CAC is above 0, and strongly above 100. Bring your exact score and LDL number to your next appointment.
Non-Calcified Plaque Soft, unstable plaque doesn't show up on a CAC scan — even at a score of 0. Keep tracking LDL/apoB and lifestyle habits even with a reassuring score.

The Framework, Visually

Low-Dose CT Scan
Agatston Score Calculated
0
Very Low
1–99
Mild
100–399
Moderate
400+
Severe
Lifestyle only; rescan in 5–10 yrs Statin discussion; tighten diet + exercise Statin + risk-factor control; cardiology follow-up Aggressive lipid-lowering; treat like existing heart disease

Do This Today

  • Write down your exact score and its age/sex percentile — not just "high" or "low."
  • Ask your doctor directly: "Based on my score, should I be on a statin?"
  • Get an LDL/apoB check if you haven't had one in the last year.
  • Book a follow-up scan date now (5–10 years out if your score is 0, sooner if elevated).
  • Skip the stent conversation unless a separate test has shown an actual blockage.

"A calcium score is useful, actionable information — not a verdict."

— Bishnu Subedi, MD, FACC

Go Watch

The Agatston Score → linked to: "Mayo Clinic Minute: How a coronary calcium scan assesses heart attack risk" (Mayo Clinic)

Power of Zero → linked to: "Power of Zero: Coronary Artery Calcium Journey — Screening Test to Decision Tool" (Dr. Khurram Nasir, HMH Grand Rounds)

Score ≠ Blockage → linked to: "Coronary Artery Calcium Score (CAC) — Can It Predict A Heart Attack?" (Talking with Docs)

Get the Book

If you've ever stared at your own calcium score wondering what to do next, this is the book to hand your future self — 21 chapters of straight answers, myth-busting tables, and questions to bring to your own cardiologist.

Go Deeper

This post contains an Amazon affiliate link. As an Amazon Associate I earn from qualifying purchases, at no extra cost to you.

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Coronary Calcium Score: Now What Do I Do? You got a number that scared you more than any lab result ever has. Here's what it a...