Does adding Coronary Artery Calcium Score (CACS) to traditional CVD risk assessment equations improve risk discrimination?
Adding CACS to traditional risk scores provides modest discrimination gains that may be outweighed by costs and risks, with no current evidence of clinical benefit.
This systematic review and meta-analysis found that the CACS appears to add some further discrimination to the traditional CVD risk assessment equations used in these studies, which appears to be relatively consistent across studies. However, the modest gain may often be outweighed by costs, rates of incidental findings, and radiation risks. Although the CACS may have a role for refining risk assessment in selected patients, which patients would benefit remains unclear. At present, no evidence suggests that adding CACS to traditional risk scores provides clinical benefit.
Bell et al. (Mon,) studied this question.