Coronary artery calcium (CAC) is an essential indicator of coronary artery disease and the Agatston score serves as a reliable, reproducible, and widely accessible tool for risk assessment, prediction of adverse cardiovascular events, and treatment guidance, in both asymptomatic and symptomatic individuals [1]. The European Society of Cardiology and American Heart Association guidelines recommend a two-step computed tomography (CT) approach for coronary artery disease assessment for symptomatic …