Key result
Zero CAC linked to ~73% lower 10-year CHD risk versus CAC >0 in high-risk adults.
Why the study?
Does a coronary artery calcium (CAC) score of zero identify a lower risk of hard CHD events in adults with high calculated ASCVD risk?
Cohort (n=1,608)
Does a coronary artery calcium (CAC) score of zero identify a lower risk of hard CHD events in adults with high calculated ASCVD risk?
Hazard Ratio: 0.27 (95% CI 0.15–0.49)
Absolute Event Rate: 3.52% vs 13.46%
A CAC score of zero identifies a resilient phenotype with significantly lower CHD risk among adults otherwise classified as high risk (≥20%) by standard ASCVD pooled cohort equations.
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CAC=0 may identify lower event rates among high PCE-risk adults; leaves open whether it should guide therapy de-intensification.
Orimoloye et al. (2026) conducted a cohort in High ASCVD risk (n=1,608). Coronary artery calcium (CAC) score of zero vs. CAC >0 was evaluated on Hard CHD events (HR 0.27, 95% CI 0.15-0.49). A coronary artery calcium score of zero was associated with a lower 10-year risk of hard CHD events compared to CAC >0 among adults with high estimated ASCVD risk (HR 0.27; 95% CI 0.15-0.49).
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