FACT: for asymptomatic adults evaluating atherosclerotic cardiovascular risk, CAC is the single most predictive test ever validated for individual prognosis. INDIVIDUAL PROGNOSIS = the actual patient in question. Me. Or you if you go see your doc.
No, you still over state the case, even though you have repeatedly quoted parts of source that contradict that. Plenty of people with diabetes or strong family histories are asymptomatic. Read your own posts.
For my case, CAC is not only diagnostic, but predictive. It's necessary and sufficient to allow ME to confidently refuse statins, for now, based on actually evaluating actual disease...in me.
If I had listened to my young, inexperienced, uncurious PA, I'd be unnecessarily taking stains today. And my risk of harm would be double my risk of benefit.
Yeah, your CAC of three says you have coronary artery disease and based on your own posts a 3% risk of a major coronary event in the next 10 years assuming you are 45 or older. If younger that 45, don't count on that data. As as stated earlier, the NNT for 3% risk is 100, your own cited NNH with a statin was 200. A CAC of 3 is not zero and cannot be treated as a zero.
You also pointed out that just getting a proper BP dropped your risk enough to keep a statin from being recommended. In other words, other than giving you a small dose of radiation and relieving you of a small sum of money, the test didn't actually change anything.
Now, some of that is based on the impression that your goal is to avoid statins. If my impression is wrong, and you would have strongly wanted a statin if the CAC was elevated, then the test did serve a useful purpose in your case. Your treating a CAC of 3 as equivalent to a 0 reinforces this.
80ish% of the time, when I offer a CAC, but push for a verbal commitment to start a statin if it is elevated above 100, most people decide they don't want it, because their mind is already made up and they are only interested in confirmation, not actually assessing risk. They leave stating intent to eat healthier, loose weight, exercise more, Etc, then return in a year and 80ish% of the time have changed nothing. That is the sad reality of preventative care.
Some people make massive changes, it feels like most of the ones that do that also take advice. It is awesome to see someone come back healthier and get to strip away meds, I whish it happened more.