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CAC is useful in some cases but combination of aggressive hype, sloganeering, & over promotion (including by non docs) leads to many cases where it isn't helpful but *is* possibly harmful Sadly, energy driving this is often for the wrong reasons - opening door to CCTA, plaque analysis & further testing-treatment cascades

“The main objective of this study was to determine the prevalence of significant CAD [coronary artery disease] (≥70% diameter stenosis) in patients with ZCS [zero calcium score] and prognostic value of the latter in a large cohort of patients with stable symptoms over a long-term follow-up.”

In symptomatic adults with a coronary artery calcification (CAC) score of zero, elevated levels of low-density lipoprotein (LDL) cholesterol were associated with increased risks for noncalcified plaques and future coronary heart disease events, especially in those younger than 45 years. https://t.co/DxX7fLp2DQ

Can AI help us safely ignore most coronary plaques? 🤯 🧠 YES — and it starts with a cut-off. 🚨 JUST PUBLISHED in EHJ-CVI! 🚨 It's all about the plaque! Yes it is. And Cardiac CT is the main tool to make the difference in clinical practice for our patients. 🫀 In the era of AI-guided CCTA, 96–97% of patients show some plaque. But not all plaque equals risk. This study delivers a game-changing solution: 👉 A validated AI-based safety cut-off for long-term ACS risk based on Percent Atheroma Volume (PAV). 📊 PAV < 2.6% = ✅ low long-term ACS risk (NPV: 99%!) 💥 PAV ≥ 2.6% = 🚨 5–7x ↑ risk of ACS 🧬 Validated in two independent cohorts with up to 7 years of follow-up! ✨ Why it matters: 🔍 AI can detect plaque with unmatched sensitivity — but we need to discriminate risk to avoid overdiagnosis. 🏁 This cut-off enables smarter triage and long-term reassurance for nearly half of all patients with suspected CAD. 🧠 It’s not about just finding plaque anymore. It’s about knowing what NOT to worry about. 👏 A major leap for AI in cardiovascular imaging. 📄 Bär et al., EHJ-CVI (2025) 👉 https://t.co/QEJD56djd7 #Cardiology #CardiacCT #CCTA #ArtificialIntelligence #Atherosclerosis #RiskStratification #PercentAtheromaVolume #PreventiveCardiology #MedicalAI #EHJCVI #CardioTwitter 🫀📉🧠🤖📊