# The CAC score and the power of zero: the heart test that measures the disease, not the risk

A coronary artery calcium (CAC) score of zero is one of cardiology's strongest reassurances: in the MESA study it carried a "warranty period" of roughly 3 to 7 years, and only about 8 percent of people who started at zero passed a CAC of 100 within a decade. It measures calcified plaque directly rather than estimating risk, which is why it can tip the statin decision for symptom-free adults around 40 to 70 at intermediate risk. But a zero is not zero risk: it cannot see soft plaque, and smoking, diabetes, or high Lp(a) still count.

A coronary calcium scan counts the plaque you already have. A zero buys you years of reassurance. Think of it as a tie-breaker when your risk is in the middle, not a test for everyone, and remember it cannot see soft plaque.

## On this page

- What is a coronary artery calcium (CAC) score and why is a zero so powerful?
- What does a high CAC score mean and when does it change your treatment?
- Should you get a CAC scan, and who is it actually for?
- How does a CAC scan work and how much radiation does it involve?
- What does a CAC scan cost in Germany, Austria, and Switzerland, and does insurance pay?
- Why does a CAC of zero not exclude soft plaque, and how do ApoB and Lp(a) fit in?

## FAQ

- What is a good CAC score for my age?
- Is a coronary calcium score worth it?
- Can a CAC score of zero be wrong or miss a heart attack risk?
- How often should you repeat a coronary calcium scan?
- Does a high CAC score mean I need a statin?
- How much does a coronary calcium scan cost in Germany?
- Should I get a CAC scan or test ApoB and Lp(a) first?

## Sources

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_Full guide: https://longevity-switzerland.com/en/guide/cac-score-herz-ct-power-of-zero_

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_Canonical: https://longevity-switzerland.com/en/guide/cac-score-herz-ct-power-of-zero · Part of Longevity Cities · Updated 2026-06-22_