thank you for your thoughtful response
This is an interesting and somewhat complex question without an easy answer. It is true that cholesterol plaques in the coronary arteries are often associated with significant calcification and that higher calcium scores are associated with presence of coronary disease. With that said, some people have significant cholesterol plaque in the absence of significant calcification (with low calcium scores). While low calcium score is a very good thing, it is not the only factor in determining need for treatment of high cholesterol. Other factors like family history or coronary disease, age, h/o high bp, smoking, and diabetes should also factor into this equation. Also current guidelines of cholesterol management do not factor in calcium score into the determination of whether treatment is needed for high cholesterol. While having a low calcium score suggests lower risk of having significant plaque accumulation, it is not the only factor and we do not generally use this as the sole factor to determine need for cholesterol treatment. In regards to need for repeat calcium scoring, there is no current guidelines that I know of that would recommend biannual calcium scoring. Calcium scoring is a fairly new thing and different doctors use it in different ways. I would recommend having a discussion with your doctor about what other risk factors you may have for coronary disease. I hope this helps.