Abstract：
Personalizing risk assessment and treatment decisions for the primary prevention of atherosclerotic cardiovascular disease (ASCVD) rely on pooled cohort equations and increasingly coronary artery calcium (CAC) score. A growing body of evidence supports that elevated CAC scores correspond to progressively elevated ASCVD risk, and that scores of ≥100, ≥300, and ≥1000 denote risk that is equivalent to certain secondary prevention populations. This has led consensus guidelines to incorporate CAC score thresholds for guiding escalation of preventive therapy for lowering low-density lipoprotein cholesterol goals, initiation of non-statin lipid lowering medications, and use of low-dose daily aspirin. As data on CAC continues to grow, more decision pathways will incorporate CAC score cutoffs to guide management of blood pressure and cardiometabolic medications. CAC score is also being used to enrich clinical trial study populations for elevated ASCVD risk, and to screen for subclinical coronary atherosclerosis in patients who received chest imaging for other diagnostic purposes.
摘要：
动脉粥样硬化性心血管疾病（ASCVD）一级预防的个性化风险评估和治疗决策依赖于合并的队列方程和越来越多的冠状动脉钙（CAC）评分。越来越多的证据支持CAC评分升高与ASCVD风险逐渐升高相对应，评分≥100,≥300和≥1000表示与某些二级预防人群相当的风险.这导致共识指南纳入CAC评分阈值，以指导降低低密度脂蛋白胆固醇目标的预防性治疗的升级。开始使用非他汀类药物降脂药物，每日服用低剂量阿司匹林。随着CAC数据的持续增长，更多的决策路径将纳入CAC评分截止值,以指导血压和心脏代谢药物的管理.CAC评分也被用于丰富ASCVD风险升高的临床试验研究人群，并对接受胸部影像学检查用于其他诊断目的的患者进行亚临床冠状动脉粥样硬化筛查。
