Table 2. Summary of studies of different designs conducted between 2005-2019 that link the relationship between CAC score and CAD in asymptomatic individual.

MESA- Multi-Ethnic Study of Atherosclerosis, CARDIA - Coronary Artery Risk Development in Young Adults, FSH - Framingham Heart Study, CAC - coronary artery calcium, CAD - coronary artery disease, CHD - coronary heart disease, CVD - coronary vascular disease, MPI - myocardial perfusion imaging

References	Study Year	Design	Sample population	Age of the participants	Percentage with CAC >0 at baseline examination	Conclusion
MESA [33]	2005	Prospective multicenter cohort	6,814	45-84, mean age: 62.2 ± 10.2	Men: 52%– 70%, women: 35%–45%	Beyond known risk factors, CAC reliably predicted cardiovascular risk in all four ethnic groups, with similar strength in all four ethnic groups..
Dennis et al. [36]	2010	Prospective study	263	30-62, mean age: 46	49%	On a five-year follow-up 1% of the 133 patients with a CAC score of 0 developed cardiac chest discomfort.  The absence of CAC suggests an excellent long-term prognosis.
CARDIA [35]	2017	Prospective community-based study	5115	32-56, mean age 40.3		After surveillance for 30 years, it concluded that a CAC score of 100 or above was linked to a higher risk of mortality. Adults under the age of 50 who have any CAC found on a computed tomographic scan, even with extremely low scores, are at an increased risk of clinical CHD, CVD, and mortality.
FHS Study [34]	2017	Observational cohort study	3,238	Men >35, women >40, mean age 49 ± 10.9	Men: 40.5%, women: 20.6%	The presence and extent of coronary artery calcium (CAC) are associated with increased risk for cardiovascular events.
Dekker [37]	2019	Observational cohort study	1265	Mean age 67.6	94%	CAC scores combined with MPI increase the diagnosis of obstructive coronary artery disease in people who have never had a revascularization procedure.