A zero coronary calcium score was obtained in out study in 28.33 % participants of which only 4 (13.35% of cases) patients who developed ACS had a zero CACS, while 13 (43.3% of controls ) people among control had a zero CACS. In this study, we analysed the distribution of Coronary artery calcium scores in patients of ACS who do not have traditional risk factors namely obesity, diabetes, smoking, dyslipidemia, hypertension was significantly different as compared to asymptomatic people without CAD and having none of above mentioned risk factors. Even though there were no traditional risk factors coronary calcium scores were significantly higher in patients who developed ACS as compared to controls