The article presents the data from population studies that show the role of the coronary calcium in the predicting of acute coronary events in patients with various cardiovascular risks. In accordance with international guidelines it is paid special attention to the assessment of coronary calcification in the group with moderate cardiovascular risk. On the example of the patient with acute myocardial infarction it is discussed the influence of the values of coronary calcium on the development of acute coronary syndrome. This clinical case demonstrates that the high risk of acute myocardial infarction is maintained even in the absence of the majority of traditional risk factors.