# CAC — Coronary artery calcium (Agatston) categories

> Risk categories based on the Agatston coronary artery calcium score.

**Situação:** vigente · **Órgão:** Cardíaco · **Órgão emissor:** Cardiac imaging consensus · **Versão:** 1990 · **Ano:** 1990

## Procedência e vigência
- Família: léxico
- Tipo de lógica: flat
- Modalidade: CT
- Fonte primária: Agatston AS, Janowitz WR, Hildner FJ, et al.. Quantification of coronary artery calcium using ultrafast computed tomography (1990) — https://doi.org/10.1016/0735-1097(90)90282-T
- Última verificação: 2026-06-26
- Última checagem: 2026-06-26

## Categorias

| Código | Rótulo | Critérios | Conduta | Risco | Localizador | Verificado |
| --- | --- | --- | --- | --- | --- | --- |
| 0 | No identifiable calcium | Agatston score of 0: no identifiable calcified coronary plaque on the gated noncontrast CT (no calcific lesions reaching the detection threshold across the proximal coronary arteries). | With a score of 0 and no other major risk factors, statin therapy is generally not indicated; the finding supports deferring or withholding pharmacologic prevention and reassessing later. (Final decisions follow ASCVD-prevention guidelines.) | 'No identifiable disease'; extremely low risk of cardiovascular events. A zero score is described as the most powerful negative predictor (the 'power of zero') in asymptomatic patients; the original 1990 cohort reported a negative predictive value of 94-100% for clinical coronary disease across the 40-69y groups. | Severity label, risk interpretation and statin guidance from StatPearls 'Coronary Artery Calcification' (NBK519037), CAC interpretation / clinical-significance and management sections ('0 = No identifiable disease'; 'power of zero'; 'CAC = 0 with no other risk factors: no statin indicated'). NPV figure from Agatston 1990 abstract. | ✓ |
| 1-99 | Mild | Agatston score 1-99: a small amount of calcified coronary plaque (mild calcified plaque burden). | Statin therapy is generally initiated in patients older than ~55 years; in younger patients (<55) statin may be withheld with reassessment in ~3-5 years. | 'Mild disease' / mild calcified plaque burden, conferring modestly increased cardiovascular risk above a zero score. | StatPearls NBK519037, CAC severity bands and management ('1 to 99 = Mild disease'; 'CAC 1-99, age >55: initiate statin'; 'CAC 1-99, age <55: statin can be withheld; reassess in 3-5 years'). | ✓ |
| 100-399 | Moderate | Agatston score 100-399: a moderate amount of calcified coronary plaque (moderate calcified plaque burden). | Statin therapy is recommended (CAC over 100 generally warrants statin). | 'Moderate disease' / moderate calcified plaque burden, with progressively elevated cardiovascular risk relative to lower bands. | StatPearls NBK519037, CAC severity bands and management ('100 to 399 = Moderate disease'; 'CAC >100: statin therapy recommended'). | ✓ |
| >=400 | Severe | Agatston score 400 or higher: an extensive amount of calcified coronary plaque (severe calcified plaque burden). | Statin therapy is recommended (score over 100 warrants statin); a score over 400 is widely regarded as severe and may prompt further cardiovascular evaluation. | 'Severe disease' / extensive calcified plaque burden; a CAC over 400 is associated with worsened clinical outcomes and correlates with advanced/obstructive coronary disease. | StatPearls NBK519037, CAC severity bands, clinical-significance and management ('Greater than 400 = Severe Disease'; 'A CAC score over 400 is associated with worsened clinical outcomes'; 'CAC >100: statin therapy recommended'). | ✓ |

### Citações por categoria
- **0**: Agatston AS, Janowitz WR, Hildner FJ, et al.. Quantification of coronary artery calcium using ultrafast computed tomography (1990) — https://doi.org/10.1016/0735-1097(90)90282-T · Severity label, risk interpretation and statin guidance from StatPearls 'Coronary Artery Calcification' (NBK519037), CAC interpretation / clinical-significance and management sections ('0 = No identifiable disease'; 'power of zero'; 'CAC = 0 with no other risk factors: no statin indicated'). NPV figure from Agatston 1990 abstract.
- **1-99**: Agatston AS, Janowitz WR, Hildner FJ, et al.. Quantification of coronary artery calcium using ultrafast computed tomography (1990) — https://doi.org/10.1016/0735-1097(90)90282-T · StatPearls NBK519037, CAC severity bands and management ('1 to 99 = Mild disease'; 'CAC 1-99, age >55: initiate statin'; 'CAC 1-99, age <55: statin can be withheld; reassess in 3-5 years').
- **100-399**: Agatston AS, Janowitz WR, Hildner FJ, et al.. Quantification of coronary artery calcium using ultrafast computed tomography (1990) — https://doi.org/10.1016/0735-1097(90)90282-T · StatPearls NBK519037, CAC severity bands and management ('100 to 399 = Moderate disease'; 'CAC >100: statin therapy recommended').
- **>=400**: Agatston AS, Janowitz WR, Hildner FJ, et al.. Quantification of coronary artery calcium using ultrafast computed tomography (1990) — https://doi.org/10.1016/0735-1097(90)90282-T · StatPearls NBK519037, CAC severity bands, clinical-significance and management ('Greater than 400 = Severe Disease'; 'A CAC score over 400 is associated with worsened clinical outcomes'; 'CAC >100: statin therapy recommended').

## Referências cruzadas
- _fronteira compartilhada_ → [CAD-RADS — Coronary Artery Disease Reporting and Data System v2.0](https://radcommons.laudos.ai/systems/cad-rads.md) — Calcium scoring complements CAD-RADS stenosis grading on coronary CT.


---
> Conteúdo de referência reescrito. Confira a publicação primária vigente. Não é dispositivo médico nem substitui o julgamento clínico. O radiologista responsável pelo laudo permanece o autor e o responsável.

Página HTML: https://radcommons.laudos.ai/systems/cac-agatston · JSON da API: https://radcommons.laudos.ai/api/v1/systems/cac-agatston · Índice para agentes: https://radcommons.laudos.ai/llms.txt