Fig. 1.

Atherosclerotic cardiovascular disease (ASCVD) event rates observed in the study participants categorized according to the estimated 10-years ASCVD event rates (as estimated by the Pooled cohort equation) and the coronary artery calcium (CAC). Upper panel- Data from the MESA (Multi-Ethnic Study of Atherosclerosis) study (Nasir K, et al J Am Coll Cardiol. 2015;66:1657-68); Lower panel- HNR [Heinz Nixdorf Recall (Risk Factors, Evaluation of Coronary Calcium and Lifestyle)] study (Mahabadi AA, et al JACC Cardiovasc Imaging. 2017;10:143-153).

The dotted horizontal line represents estimated 10-year ASCVD risk of >7.5%, which is the threshold recommended for statin initiation by the 2013 American Heart Association/American College of Cardiology guidelines. In almost all the risk categories except >20% risk, the observed event rates among participants with CAC = 0 were much lower than this threshold.