Abstract
Background 
 Acute myocardial infarction and sudden cardiac death was reported to be the initial presentation in 50% of patients with coronary artery disease (CAD); coronary artery calcium score can be regarded as one of the potential tools to improve risk stratification and predict coronary events in these patients.
 Objectives 
 To find the correlation between coronary calsuim score calculated by CT scan and significant coronary stenosis by conventional coronary angiography.
 Materials and Methods
 A hundred patients who were referred for conventional coronary angiography having CAC score calculated by CT scan, 50 patients with CAC <400 and 50 patients with >400 were randomly selected to be involved.
 Results
 The age ranged from 32 to 70 years with a mean of 56.7 ±8.9. There were 59 males with 41 females. Chest pain was our study’s main reason for undergoing imaging (67%). The mean coronary calcium score was 528.54 for total coronary vessels and 19,236.8, 115.45 and 157.98 for LMS, LAD, LCX and RCA, respectively. The mean of the calculated syntax score was 23.4. Stenosis of >50% was 9% for LMS, and stenosis of ≥75% was found in 41%, 27%, and 8% of LAD, LCX and RCA, respectively. A significant correlation between total coronary calcium score at a threshold of 400 and age, being diabetic, LAD stenosis, LCX stenosis, RCA stenosis, mean syntax score and syntax score categories. Also, the mean total coronary calcium score was significantly correlated to age, gender and syntax score. Moreover, the stenosis in LAD, LCX and RCA was significantly correlated to the mean of the calcium score of respective vessels. 
 Conclusion
 Total CAC score was significantly associated with angiographic coronary stenosis, and the correlation is stronger at 400 and above. This study may support using calcium screening as an initial filter before further sophisticated imaging or invasive angiography. However, a zero or low CACS does not exclude CAD.
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