What is the use of coronary artery calcium measurement for individuals with intermediate predicted risk?
Coronary artery calcium measurement can be a useful tool in refining risk assessment for preventive interventions (eg, statin therapy) for individuals with intermediate predicted risk (7.5% to <20%) by the PCE or for select adults with borderline (5% to <7.5%) predicted risk. Coronary artery calcium measurement can reclassify risk upward (particularly if coronary artery calcium score is 100 Agatston units (AU) or 75th age/sex/race percentile) or downward (if coronary artery calcium is zero) in a significant proportion of individuals. The extent of reclassification is sufficient to provide confidence that borderline- or intermediate-risk patients with elevated coronary artery calcium will have event rates that clearly exceed benefit thresholds (ie, 7.5% in 10 years) and those with coronary artery calcium scores of zero will have event rates <7.5%, which can help guide shared decision-making about statins.