Coronary artery calcium scoring for cardiovascular risk stratification: A prospective cohort study.

Traditional cardiovascular risk models fail to detect subclinical atherosclerosis in a substantial proportion of asymptomatic individuals. Therefore, it is of interest to evaluate the prognostic value of coronary artery calcium (CAC) scoring in predicting major adverse cardiovascular events over five years. Higher CAC categories were associated with progressively increased myocardial infarction, stroke and cardiovascular mortality, with CAC ≥400 demonstrating the highest event burden. Each 100-unit increase in CAC score independently increased cardiovascular risk nearly twofold (HR 1.92, p=0.001). Thus, addition of CAC scoring to traditional risk models significantly improved risk stratification with a net reclassification improvement of 0.24.