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Coronary artery calcium (CAC) scores can be used to refine cardiovascular (CV) risk prediction, but is the incremental benefit sufficient to use CAC scores in primary prevention? In this meta-analysis, investigators identified six studies that reported the incremental value of CAC scores in CV risk prediction over CV risk determined by using calculators recommended in national guidelines alone. Studies varied in size (470–5185 participants), mean patient age (50–75), and percentage of women enrolled (38%–59%).
Overall, CAC scores increased ability to identify CV risk. Participants deemed to be low risk by CV risk calculators, but who were reclassified as intermediate-to-high risk after CAC scoring, had a 4% to 14% chance of experiencing adve…