Why the study?
Guidelines recommend considering CAC scoring in intermediate ASCVD risk patients, but its utility in lower-risk individuals remains less clear.
Does the addition of coronary artery calcium (CAC) scoring improve ASCVD risk prediction in low and borderline-risk individuals?
Population
6712 participants from MESA
Comparison
CAC scoring added to PCE and AHA PREVENT equations vs equations alone
Design
Prospective cohort study
Follow-up
Median of 16.7 years
Key result
The presence of coronary artery calcium was associated with increased ASCVD risk overall (HR 1.19) and in low-risk individuals (HR 1.35), significantly improving risk prediction when added to standard equations.
Authors
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May refine ASCVD stratification in low-risk patients; extends observational data but leaves adoption open pending trials.
Cohort (n=6,712)
Yes
Does the addition of coronary artery calcium (CAC) scoring improve ASCVD risk prediction in low and borderline-risk individuals?
Effect estimate: HR 1.19 (95% CI 1.15-1.23)
Absolute Event Rate: 14.3% vs 4.1%
p-value: p=<0.001
The addition of coronary artery calcium scoring to standard risk equations significantly improves ASCVD risk prediction and reclassification in low- and borderline-risk individuals.
Davis et al. (2025) conducted a cohort in Atherosclerotic cardiovascular disease risk (n=6,712). Coronary artery calcium (CAC) scoring (CAC > 0) vs. No coronary artery calcium (CAC = 0) was evaluated on ASCVD events (HR 1.19, 95% CI 1.15-1.23, p=<0.001). The presence of coronary artery calcium was associated with increased ASCVD risk overall (HR 1.19) and in low-risk individuals (HR 1.35), significantly improving risk prediction when added to standard equations.