This review demonstrates the predictive value of coronary artery calcium scoring in primary cardiovascular prevention with aspirin, suggesting a more personalized approach.
This article critically reviews the contemporary evidence regarding the use of aspirin for primary cardiovascular disease (CVD) prevention, specifically focusing on its application guided by Coronary Artery Calcium (CAC) scoring in individuals with subclinical coronary atherosclerosis. Despite aspirin's historical role in preventing acute coronary events, its net benefit in primary prevention has been debated due to bleeding risks. CAC scoring has emerged as a powerful tool for identifying asymptomatic individuals at elevated risk due to subclinical atherosclerosis, providing a more precise risk stratification than traditional risk factors alone. This review synthesizes current literature on CAC's predictive value and the targeted use of aspirin in this specific high-risk subgroup, exploring the potential for a more personalized approach to primary CVD prevention that balances efficacy with safety.
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Thompson et al. (2025) studied this question.
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