Table 2. Clinical practice guidelines that evaluate the utility of CAC scoring in symptomatic patients.

Guideline	Recommendation
2013 ACCF multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease [14]	Rarely appropriate: Calcium scoring in symptomatic patients with low, intermediate, or high pre-test probability for coronary artery disease
2012 ACCF/AHA guideline for the diagnosis and management of patients with stable ischemic heart disease [15]	Class IIb: For patients with a low to intermediate pretest probability of obstructive ischemic heart disease, non-contrast cardiac CT to determine the CAC score may be considered
2015 ACR/ACC appropriate utilization of cardiovascular imaging in emergency department patients with chest pain [16]	Coronary calcium scoring was not considered by the rating panel because there are few data on coronary calcium scoring using multidetector CT hardware in patients who present to the emergency department in whom acute coronary syndrome is the leading differential diagnosis
2013 ESC guidelines on the management of stable coronary artery disease [17]	Class III: Coronary calcium detection by CT is not recommended to identify individuals with coronary artery stenosis

ACC, American College of Cardiology; ACCF, American College of Cardiology Foundation; ACR, American College of Radiology; AHA, American Heart Association; CAC, coronary artery calcium; CT, computed tomography; ESC, European Society of Cardiology.