Should presence of coronary artery calcifications on CT/CTA be considered as presence of vascular disease on CHA2DS2-VASc score?

This is a great question, not only for this aspect but also even defining as what counts as secondary prevention vs primary prevention, etc. The short answer is that it is not clarified in CHADSVASC, but at that time, they were more using the definition of "clinical CAD," so I generally do not count...

The question also comes up in the use of Class IC flecainide and propafenone if the patient has elevated CAC but no evidence of myocardial damage. Is IC only a concern if the LV is scarred And what is the risk if you have an MI while on IC?