Coronary artery calcium score: Current status of clinical application and how to handle the results

Another practical CAC review, this one focused on the everyday question: you have a calcium score — now what do you do with it?

The authors lay out the actionable thresholds: a score of zero signals low risk and can justify holding off on a statin, while a score of 300–400 or above marks elevated risk warranting aggressive treatment. They’re honest about the gray zone — moderate scores remain genuinely uncertain — and they position CAC as a way to refine pretest probability and complement other non-invasive imaging.

The practical takeaway is using CAC to support shared decisions about statins and further testing, especially in intermediate-risk patients or those reluctant to start medication. The status-quo angle cuts two ways: it offers a reason to defer treatment in some (the zero score) and to escalate in others.

We rate the evidence moderate: a 35-reference narrative review grounded in guidelines, no conflicts, but no new data. Its clinical significance is moderate — a useful, practical synthesis for clinicians implementing CAC, overlapping with the several other CAC reviews in this library but distinguished by its “how to handle the result” framing.