Coronary Artery Calcium (CAC) Score
Last reviewed 25 August 2026 · Evidence-graded review — see Methodology
A non-contrast CT that quantifies calcified plaque in the coronary arteries and reports it as an Agatston score. The distinction that matters here: it does not estimate risk from risk factors, it images the disease itself. Calcified plaque is a direct, visible marker of atherosclerotic burden that is already present.
Detrano R, Guerci AD, Carr JJ, et al. (MESA) “Coronary Calcium as a Predictor of Coronary Events in Four Racial or Ethnic Groups.” N Engl J Med 2008;358:1336–1345 followed 6,722 adults without known cardiovascular disease and found that a doubling of the calcium score raised the risk of a major coronary event by 15–35% across four racial and ethnic groups, independently of traditional risk factors. The 2018 ACC/AHA cholesterol guideline now incorporates CAC scoring as a formal decision aid: in intermediate-risk patients a score of zero can support deferring statin therapy, while a high score supports intensifying it. Arguably the best-evidenced “extra” test on this site.
Detrano R, et al. N Engl J Med. 2008. PubMed: PMID 18367736 · Full cost breakdown & who it's for →
Singapore guidance
Not one of the named screening tests
Singapore’s national screening committee does not review coronary calcium scoring in its current volume; its cardiovascular screening recommendations cover lipids and blood pressure, with risk stratified by the Singapore-modified Framingham Risk Score 2023.
Source: Screening Test Review Committee report 2026, Volume 1 (Academy of Medicine Singapore and Ministry of Health, February 2026). The full national list · How this is used.
What you would actually pay
- Healthier SG
- Not subsidised
- MediSave
- Not among the screenings named for outpatient claims
Source: Healthier SG Screening (HealthHub) and MediSave outpatient care (Ministry of Health). Absence from either list is not a statement that the test is discouraged — only that no subsidy or claim applies. Gross prices compared.
What it costs when it is wrong
- Basis
- No published harm criterion found
- Severity
- Not documented
No published harm criterion found for this test.
An empty finding, not a clean bill of health: this means nothing documented was found for this test. It is not a claim that the test is safe.
Screening harm is not only a laboratory question: the committee’s own criteria advise against a test when “the screening test, or follow-up tests arising from a positive screen, are associated with significant medical risks”. Sources on overdiagnosis → · How this is graded.
Singapore pricing. We have a full price breakdown for this test, using checked 2026 figures from named providers — read the price guide →
FAQ
Is the Coronary Artery Calcium (CAC) Score worth doing in Singapore?
Coronary Artery Calcium (CAC) Score carries a strong evidence grade for screening adults without symptoms. It typically costs S$300–550 in Singapore. Most appropriate for adults at intermediate calculated cardiovascular risk, to guide the statin decision. Not useful in very-low or very-high risk adults where the decision is already clear, and not recommended under ~age 40 without strong risk factors (low pre-test probability, some radiation exposure). The usual schedule: once around age 40–50 (intermediate risk); repeat testing is not usually indicated within 5 years if score is 0.
Weighing this against something else? Compare it with two other tests → · Price it inside a panel →