Don’t order coronary artery calcium scoring for screening purposes on low-risk asymptomatic individuals except for those with a family history of premature coronary artery disease.

Rationale and Comments

Net reclassification of risk by coronary artery calcium scoring, when added to clinical risk scoring, is least effective in low-risk individuals.

Budoff MJ, et al. Assessment of coronary artery disease by cardiac computed tomography. Circulation. 2006;114(16): 1761-91.
Shaw LJ, et al. Prognostic value of cardiac risk factors and coronary artery calcium screening for all-cause mortality. Radiology. 2003;228(3):826–33.