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Coronary artery calcium (CAC) testing is becoming more prevalent, but its clinical relevance and its role as a cardiovascular risk factor and in patient management is not clear. In a prospective observational study of 25,253 asymptomatic patients with cardiovascular risk factors who were referred by their primary physicians for CAC testing with electron beam tomography, researchers developed risk-assessment models using CAC scores to predict all-cause mortality. Median follow-up was 5.8 years; 26% of patients were followed for at least 10 years.
Although patients were asymptomatic, 57% had detectable calcium. After adjusting for established risk factors, mortality increased significantly with increasing CAC score. Compared with patients havi…