CAC scan utility for cardiovascular risk stratification

Thanks for asking—here’s the straight take. A CAC scan (non‑contrast CT that scores plaque calcium) is most useful to refine risk when you’re unsure about starting or intensifying prevention. If CAC=0, short‑term risk is low and you can often defer statins unless there’s diabetes, smoking, strong family history, or very high Lp(a). If CAC is >0, risk rises with score: 1–99 suggests benefit from statins if age >40; ≥100 (or ≥75th percentile) strongly supports statins and tighter LDL targets; very high scores (≥300–400) imply high plaque burden and warrant aggressive risk‑factor control. It doesn’t replace lifestyle, LDL/ApoB lowering, or symptom evaluation; it’s radiation‑light (~1 mSv) and not for people with known CAD or during unstable symptoms.