Patel J, Pallazola VA, Dudum R, et al. - Coronary artery calcium (CAC) scoring, when used as an adjunct to risk-enhancing factor evaluation, is useful in allowing a more accurate classification of persons with an intermediate risk of atherosclerotic cardiovascular disease (ASCVD) for whom statin therapy might be beneficial.

• This cross-sectional study included a multiethnic sample of 1,688 adults with an intermediate risk of atherosclerotic cardiovascular disease.

• In the absence of subclinical atherosclerosis (CAC score of 0), an absolute (ASCVD) incidence rate of less than 7.5 events per 1000 person-years was reported for most risk-enhancing factors (individual and combined).

• Significant improvements in the reclassification and discrimination of atherosclerotic cardiovascular events were achieved by using CAC scoring.

• In participants at intermediate risk with risk-enhancing factors, the observed atherosclerotic cardiovascular event rates were generally lower relative to the recommended threshold to start statin treatment when the CAC score was 0.

• Whereas, coronary artery calcium scoring may be beneficial for cases in which additional risk stratification is required or uncertainty exists about the utility of statin therapy.