Calcium Scoring vs Traditional Risk: No Difference in Cardiovascular Events

At the European Society of Cardiology Congress 2026, a Hot Line session revealed that initiating statin therapy based on coronary artery calcium (CAC) scoring does not reduce the incidence of major cardiovascular events compared with the traditional risk factor assessment approach. The findings were presented by researchers who evaluated a cohort of patients undergoing CAC scans and subsequently received statin therapy guided either by their calcium scores or by conventional risk calculators such as the SCORE or ASCVD risk equations.

The analysis, which followed participants over a median period of several years, showed no statistically significant difference in outcomes such as myocardial infarction, stroke, or cardiovascular death between the two groups. While CAC scoring remains a valuable tool for risk stratification, the study suggests that it may not provide additional benefit in guiding statin therapy beyond established risk factor models.

These results underscore the importance of continuing to rely on well‑validated risk assessment tools for statin prescribing decisions. Clinicians and guideline committees may need to reconsider the role of CAC scoring in routine practice, as its use does not appear to confer a measurable advantage in preventing major cardiovascular events.