The total Agatston score (AS) of each individual is calculated by summing the scores of every calcified focus through all of the coronary arteries. 14 Coronary artery calcium scoring has been established as a strong tool for prediction of coronary events, reflecting the burden of coronary artery disease. Calcium scoring is considered the “gatekeeper” for CCTA. Demographic details of the patient with history of risk factors, such as diabetes, hypertension, treatment for hypertension, dyslipidemia, smoking and positive family history was collected using a questionnaire which was part of the clinical research form. Indication for referral was noted. Thus, significant coronary artery disease was present even in patients with calcium score 0 & calcium scoring could not quantify vascular stenosis or assess non-calcified and mixed plaque which may have features that render the plaque as vulnerable or at high risk for rupture due to presence of a lipid core or spotty calcifications.