Addition of CAC to PREVENT-ASCVD Equations May Improve Predictive Utility in Certain Patients

THURSDAY, Aug. 27, 2026 (HealthDay News) — The addition of coronary artery calcium (CAC) scoring to the Predicting Risk of Cardiovascular Disease EVENTS (PREVENT) atherosclerotic cardiovascular disease (ASCVD) equations may modestly improve predictive utility among U.S. adults, according to a study published online Aug. 26 in the Journal of the American Medical Association.

Xiaoning Huang, Ph.D., from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues examined the change in predictive utility when adding CAC scores to the PREVENT-ASCVD equations in a longitudinal observational cohort study enrolling 6,098 adults aged 45 to 79 years without ASCVD at baseline.

At baseline, the mean estimated 10-year ASCVD risk was 6.4 percent with the PREVENT-ASCVD base equations; 49 percent of participants had a CAC score greater than 0. The researchers found that 6 percent of participants experienced an ASCVD event during 10 years of follow-up. The Harrell C statistic was 0.73 for the PREVENT-ASCVD base equations and changed by 0.02 after adding CAC to the PREVENT-ASCVD base equations; the categorical net reclassification improvement was 0.095. The calibration slope was 1.09 and 0.92 for the PREVENT-ASCVD base equations and the PREVENT-ASCVD baseline plus CAC equations, respectively. Among those at borderline risk, incident ASCVD occurred in 1.9, 3.9, 7.4, and 14.3 percent of those with CAC scores of 0, >0 and <100, ≥100 and <300, and ≥300, respectively.

“For patients at borderline risk, knowing their calcium score can help determine whether their risk is actually lower or higher than initially estimated, which can help guide treatment decisions,” senior author Nilay S. Shah, M.D., M.P.H., also from the Feinberg School of Medicine, said in a statement.

Several authors disclosed ties to the biopharmaceutical industry.

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