In asymptomatic patients, do coronary artery calcium scores predict myocardial infarction risk?

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Yes, coronary artery calcium scores (CACSs) identify patients at increased risk for outcomes such as myocardial infarction (MI) and death from coronary heart disease (CHD). However, in asymptomatic patients, due to the low pretest probability of these outcomes (<1%), a high CACS (about ≥300) has a low positive predictive value (PPV=2%-4%) over 3 to 4 years (SOR: B, consistent prospective cohort trials).

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