How should a CAC score of 350 influence risk stratification in an asymptomatic primary‑prevention patient with borderline‑to‑intermediate ASCVD risk?

I really appreciate this question because it occurs often in real-life clinical practice. Let's establish some basic grounds here: [1] Elevated coronary artery calcium (CAC) scores are predictive of high atherosclerotic cardiovascular disease (ASCVD) outcomes and major adverse cardiovascular events ...

The American College of Cardiology (ACC)/American Heart Association (AHA) guidelines do not recommend stress testing in asymptomatic patients with elevated coronary artery calcium (CAC) scores. The 2010 guidelines recommended stress testing in asymptomatic patients with a CAC score greater than 400 ...