Predictive Utility of Coronary Artery Calcium Score Added to the PREVENT Atherosclerotic Cardiovascular Disease Equations.

Adding coronary artery calcium scores to PREVENT-ASCVD equations modestly improves risk prediction, with a 0.02 increase in Harrell C statistic in US adults aged 45-79.

• Why it matters: Accurate risk stratification is essential for guiding preventive strategies in cardiovascular disease, yet the benefit of incorporating CAC scores alongside existing risk models remains uncertain, especially for those with borderline or intermediate risk.
• What they did: Researchers analyzed data from 6 US sites involving 6,098 adults without ASCVD, comparing 10-year risk estimates before and after adding CAC scores using performance metrics like Harrell C, calibration, and net reclassification improvement.
• The result: The addition of CAC scores yielded only slight improvements in predictive accuracy overall, with notable reclassification mainly in borderline to intermediate risk groups, supporting selective use of CAC testing in these populations.