Abstract
Introduction: Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of mortality in the United States. Coronary artery calcium (CAC) has emerged as a powerful screening tool for major adverse cardiovascular events (MACE). A CAC of zero is regarded as a badge of assurance of a low 5-year MACE. Patients with a CAC of zero may subsequently not be placed on aggressive lipid-lowering therapy. In addition, CAC severity and percentiles are used to help guide treatment decisions on lipid-lowering therapy. Many studies, however, show a non-zero event rate despite CAC of zero. Therefore, we investigated if carotid doppler assessment could further help risk-stratify primary prevention patients beyond CAC.
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