Which CAC score indicates a MACE risk equivalent to those treated for ASCVD?

• A. >300
• B. 100
• C. 200
• D. 300

Answer: (A)

Calcium scoring measures how much calcium is in the coronary arteries, which reflects the burden of atherosclerotic plaque. As the score climbs, the risk of major adverse cardiovascular events rises, and once it passes a high threshold, that risk becomes comparable to the risk seen in people with known ASCVD who are on therapy. A CAC score greater than 300 indicates this level of risk equivalence, meaning the likelihood of events is similar to those treated for ASCVD, and it supports adopting similarly intensive preventive measures (for example, stronger statin therapy and aggressive risk-factor management). Earlier thresholds like 100 or 200 show elevated risk but do not reach the same level of risk as established ASCVD, so they don’t meet the same equivalence.