How to Use a Coronary Artery Calcium Score: Is a Statin Needed?

Michael Shapiro, MD

The decision to prescribe a statin to prevent ASCVD may require considering factors in addition to global CVD risk. A short case illustrates use of the CAC score.

The 2018 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults includes recommendations on how to refine cardiovascular risk assessment to determine the need for pharmacotherapy in primary prevention; obtaining and using a measure of coronary artery calcium is one.

Are you familiar with the cut points for shared decision making with patients? Follow the case below. What would you recommend based on Annett's score?


Michael Shapiro, DO, is Fred M. Parrish Professor of Cardiology and Molecular Medicine at Wake Forest University where he is faculty in the Section of Cardiovascular Medicine. He is also director of the Center for Preventive Cardiology at Wake Forest Baptist Health.