Opportunistic Detection of Coronary Artery Calcium on Non-Cardiac Chest Computed Tomography: An Emerging Tool for Cardiovascular Disease Prevention
Published: October 16, 2025
- Coronary artery calcium (CAC) is a marker of subclinical atherosclerosis and is strongly linked to an increased risk of atherosclerotic cardiovascular disease events. When measured via non-contrast cardiac computed tomography, CAC improves risk stratification beyond traditional risk factors and can aid in decision-making for allocation of preventive treatments.
- Although national guidelines recommend consideration of CAC measurement for individuals with borderline-to-intermediate 10-year atherosclerotic cardiovascular disease (ASCVD) risk, adoption has been limited despite the over 17 million eligible individuals for CAC scoring in the United States. A promising approach to bridge this gap is opportunistic detection of coronary artery calcium (ODCAC) using non-electrocardiogram-gated chest computed tomography scans that are performed for a non-cardiac indication.
- This scientific statement examines the systematic approaches needed to ensure appropriate reporting, interpretation, and action, while avoiding unnecessary downstream testing. Implementation that includes tailored preventive care and streamlined care pathways involving multidisciplinary clinical teams including radiology, cardiology, and primary care is essential.