Table 1.

Recommendations for coronary artery calcium testing according to recent guidelines

Guideline	Recommendations for CAC testing
2013 American College of Cardiology/American Heart Association Guidelines3,4	IIb indication; level of evidence B “if, after quantitative risk assessment, a risk-based treatment decision is uncertain, assessment (of CAC) may be considered to inform treatment decision making.”a
2012 European Society of Cardiology Guidelines5	IIa indication; level of evidence B “(CAC) should be considered for cardiovascular risk assessment in asymptomatic adults at moderate risk”
2010 Appropriate Use Criteria for Cardiac CT6
Appropriate	Intermediate risk OR low risk and family history of premature CADb
Inappropriate	Low risk AND no family history of premature CADb
Uncertain	High risk

CAD, coronary artery disease; ASCVD, atherosclerotic cardiovascular disease; LDL-C, low-density lipoprotein cholesterol.

^aAfter discussion with patient when decision to initiate statin therapy is unclear among selected individuals who are not in one of the four statin benefit groups, defined as those with (i) clinical atherosclerotic cardiovascular disease, (ii) primary elevation of LDL-C ≥190 mg dl⁻¹, (iii) age of 40–75 years with diabetes and LDL-C of 70–189 mg dl⁻¹ or (iv) age of 40–75 years without clinical ASCVD or diabetes and LDL-C of 70–189 mg dl⁻¹ and estimated 10-year ASCVD risk ≥7.5%.

^bFirst-degree relative male <55 years of age or female <65 years of age.