Table 2.

Summary of 4 Major Guidelines and Expert Consensus Documents on Use of CAC for Risk Assessment in Asymptomatic Patients

Guideline/Statement	Summary of CT Recommendations
2013 ACC/AHA Risk Assessment Guideline	If, after quantitative risk assessment using traditional risk factors, a risk-based treatment decision is uncertain, CAC score may be considered to inform treatment decision-making. Class IIb, Level of Evidence: B (7).
2016 European Guidelines on CVD Prevention	CAC scoring may be considered as a risk modifier in CV risk assessment. Class IIb, Level of Evidence: B (8).
2017 Expert Consensus from the Society of Cardiovascular Computed Tomography	It is appropriate to perform CAC testing in the context of shared decision making for asymptomatic individuals without clinical ASCVD who are 40–75 years of age in the 5%–20% ten-year ASCVD risk group and selectively in the <5% ASCVD risk group, such as those with a family history of premature CAD (91).
2018 U.S. Preventive Services Task Force Draft Guideline on Non-Traditional Risk Factors	In asymptomatic adults, the current evidence is insufficient to assess the balance of benefits and harms of adding CAC score to traditional risk assessment for CVD prevention. Class I (123).

ASCVD = atherosclerotic cardiovascular disease; CT = computed tomography CVD = cardiovascular disease. Other abbreviations as in Table 1.