Establishment of Predictive Value of Coronary Calcium Scoring in Correlation of CT Angiography in Clinically Suspected Patients

Background:. Coronary artery disease (CAD) is a major cause of morbidity and mortality. Coronary artery calcium (CAC) scoring provides a non-invasive assessment of calcified atherosclerotic burden and may assist in predicting coronary stenosis. Aims and Objectives: To evaluate the predictive value of CAC scoring and its correlation with coronary CT angiography (CCTA) findings in clinically suspected CAD. Materials and Methods: This prospective observational study included 196 patients with clinically suspected CAD at the Department of Radio-Diagnosis, Maharani Laxmi Bai Medical College, Jhansi, from March 2025 to February 2026. CAC was quantified using the Agatston method and correlated with coronary stenosis severity Results: The mean age was 49.6 years, and 57.1% were male. Diabetes mellitus was the most common risk factor. The mean CAC score was 79.6±127.9. CAC showed a significant moderate positive correlation with maximum stenosis severity (r=0.543, p<0.001). At a CAC threshold ≥100, sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for significant CAD were 38.5%, 100%, 100%, 56.5%, and 65.8%, respectively. Conclusion: Increasing CAC scores were significantly associated with greater coronary stenosis. CAC scoring is useful for risk stratification and identifying patients at increased risk of significant CAD; however, low or zero CAC cannot reliably exclude obstructive disease and should be interpreted alongside clinical findings and CCTA.