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Question:

Is ZERO the only good score on a calcium score test?

Is ZERO the only good score on a calcium score test? And is a zero score common/uncommon? Is it seen in typical healthy people, or only in very fit individuals, i.e., people who run two hour marathons and/or those who climb Mt Everest?

Submitted by Rich from Pittsburgh, Pennsylvania on 06/02/2016

Answer:
by Scott R. Sherron, MD

Zero is clearly the best score and is the “normal” score. Calcium is a marker for plaque and is attracted to plaque in the coronary vessels. While it is technically abnormal to have any plaque, it is extremely common to develop at least some plaque with age, so that a percentile scoring system was developed to allow comparisons to others in same age range. Most cardiologists will also treat a score of up to 10 as essentially normal. Furthermore, the score can be used to very loosely assess overall plaque burden. However, there is a large variation in the tendency to calcify plaque and therefore the same amount of plaque can vary widely in Ca score. There is also some delay between the formation of plaque and the deposition of calcium so that it is possible to have a Ca score of zero even with some plaque present. Still, a zero score is very reassuring. Many generally healthy people of all ages have a zero Ca score. It is not limited to super athletes. Mainly, Ca scoring is useful as a risk stratification tool and can help decide who to screen for silent coronary disease (and how often) as well as guide the aggressiveness of cholesterol treatment.