Aug 28, 2026 · 13 min · 11 segments
Editor's Summary by Linda Brubaker, MD, and Preeti Malani, MD, MSJ, Deputy Editors of JAMA, the Journal of the American Medical Association, for articles published from…
Preeti MalaniHostLinda BrubakerHost
Recommendations for statin use and other preventative measures are typically based on risk estimates.
Dr. Wang and colleagues evaluated whether adding a coronary artery calcium, or CAC score, improves the risk assessment based on the newer prevent equations for atherosclerotic cardiovascular disease risk or ASCVD.
This is a longitudinal cohort study of more than six thousand US adults aged forty-five to seventy-nine years without atherosclerotic cardiovascular disease at baseline.
The mean estimated ten-year ASCVD risk for all participants was six point four percent.
For the overall study population, adding the CAC score only modestly improved overall prediction, but the more clinically useful signal was in people at borderline risk, where the event rate was one point nine percent when the CAC score was zero, but it rose to fourteen point three percent when the CAC score was three hundred or higher.
The authors conclude that the CAC score may be most helpful when the prevent equation puts a patient in the borderline to intermediate risk zone, and more information could inform a recommendation for preventative measures, including statin use.
That's an important distinction because the new dyslipidemia guideline recommends selective CAC testing in adults with borderline to intermediate predicted risk.
This new information lets clinicians know what the CAC score adds when the prevent risk assessment is already being used.
Recommendations for statin use and other preventative measures are typically based on risk estimates.
Dr. Wang and colleagues evaluated whether adding a coronary artery calcium, or CAC score, improves the risk assessment based on the newer prevent equations for atherosclerotic cardiovascular disease risk or ASCVD.
This is a longitudinal cohort study of more than six thousand US adults aged forty-five to seventy-nine years without atherosclerotic cardiovascular disease at baseline.
The mean estimated ten-year ASCVD risk for all participants was six point four percent.
For the overall study population, adding the CAC score only modestly improved overall prediction, but the more clinically useful signal was in people at borderline risk, where the event rate was one point nine percent when the CAC score was zero, but it rose to fourteen point three percent when the CAC score was three hundred or higher.
The authors conclude that the CAC score may be most helpful when the prevent equation puts a patient in the borderline to intermediate risk zone, and more information could inform a recommendation for preventative measures, including statin use.
That's an important distinction because the new dyslipidemia guideline recommends selective CAC testing in adults with borderline to intermediate predicted risk.
This new information lets clinicians know what the CAC score adds when the prevent risk assessment is already being used.
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