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ACCSAP CCKE Coronary Artery Disease (CAD) Risk Stratification And Prevention Practice Test

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In risk assessment, which tool can be used to further refine risk stratification for a patient with 5-20% 10-year ASCVD risk?
Correct Answer:
CAC scoring
Explanation:
Coronary artery calcium scoring uses a CT scan to measure calcified plaque in the coronary arteries. In people with an intermediate 10-year ASCVD risk (around 5-20%), this test adds prognostic information beyond traditional risk factors and helps reclassify risk to guide preventive therapy. A zero CAC score can suggest lower short-term risk and may support a less aggressive approach if risk factors are favorable, while any detectable calcium indicates higher risk and can push toward initiating or intensifying statin therapy. Echocardiography, stress testing, and Holter monitoring assess heart structure, ischemia, or rhythm, not long-term ASCVD risk in asymptomatic individuals. Therefore, CAC scoring is the most appropriate tool to refine risk in this scenario.

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