Work

Coronary Calcium Scoring for Subclinical Atherosclerosis Detection in Asymptomatic Middle-Aged Adults: Risk Reclassification, Treatment Decisions, and One-Year Statin Initiation Patterns

Year: 2026

Type: article

Abstract: Coronary artery calcium score (CACS), measured by non-contrast cardiac CT, provides a direct measure of subclinical atherosclerosis with strong prognostic value beyond conventional cardiovascular risk equations. We assessed the impact of CACS testing on risk reclassification and statin initiation in 380 asymptomatic middle-aged adults (198 men, 182 women) referred from primary care for cardiovascular risk assessment. Most participants (152, 40.0%) had a CACS of zero, while 70 (18.4%) had a score above 300. Compared with the conventional pooled-cohort ASCVD risk equation alone, the addition of CACS reclassified 41.6% of participants 23.2% downward to a lower treatment-decision category and 18.4% upward. Statin initiation among intermediate-risk participants rose from 42% before CACS testing to 68% after, while statin de-escalation occurred in 47 patients (12.4%) with CACS of zero who had previously been on therapy. CACS testing meaningfully reshaped treatment decisions in a real-world preventive cardiology population and supports its incorporation into shared decision-making for primary prevention.

Source: Zenodo (CERN European Organization for Nuclear Research)

DOI: 10.5281/zenodo.20410027

Authors: Dr. Subhash Chand Sylonia, Dr. Supriya Maitiy, Mrs. Sudha Gautam

Language: English

Topic: Cardiac Imaging and Diagnostics

Subfield: Radiology, Nuclear Medicine and Imaging

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: green

OpenAlex ID: W7162502972

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