Research · PMID 42291041
Reviewed by Neal Rouzier, MD, Preventive Medicine · Sep 2026
Incremental prognostic value of coronary artery calcium progression within a large community-benefit calcium score registry.
American journal of preventive cardiology · June 2026 · Michael D Glidden, Santosh K Sirasapalli, Mark Yoder, Jean-Eudes Dazard, Zhuo Chen, et al.
What this study found
Serial CAC imaging may provide incremental prognostic value in individuals with pre-existing atherosclerosis. While incident CAC after a baseline zero score may confer limited short-term risk, it may present a window for preventive intervention.
How RAGMD uses this study
Clinical questions this paper informs
Synthesis lives on the evidence question — this page shows where the study sits in that analysis.
Core study
Should coronary artery calcium scoring guide statin decisions?
Coronary artery calcium can reclassify intermediate-risk patients and inform statin initiation when risk is uncertain. A score of zero may support deferring therapy in selected low-risk individuals with shared decision-making.
Open evidence analysisSupporting literature
Is ApoB more useful than LDL-C for cardiovascular risk prediction?
Prospective cohorts and meta-analyses suggest ApoB may capture atherogenic particle burden better than LDL-C alone, particularly when triglycerides are elevated or LDL particles are discordant with LDL-C.
Open evidence analysisSupporting literature
Should adults take statins for primary cardiovascular prevention?
Meta-analyses of primary prevention trials show reduced major adverse cardiovascular events with statins in appropriately selected moderate-to-high-risk adults. Shared decision-making should weigh absolute risk reduction against side effects and patient preference.
Open evidence analysisSupporting literature
Does elevated lipoprotein(a) independently increase cardiovascular risk?
Mendelian randomization and epidemiologic data support Lp(a) as a causal cardiovascular risk factor. Specific Lp(a)-lowering therapies are emerging but routine treatment beyond standard risk factor control awaits outcome trial confirmation.
Open evidence analysisSupporting literature
Do therapies that raise HDL reduce cardiovascular events?
Trials of niacin and CETP inhibitors raised HDL without consistent reduction in cardiovascular events when added to statins, challenging the hypothesis that raising HDL alone is protective.
Open evidence analysis