A CT angiogram may be appropriate for individuals who are more risk-averse, prefer not to take statins, or have a zero calcium score but other risk factors.

“But if you're building up a lot of soft plaque in your artery that hasn't yet calcified and you're going around saying, "I have a calcium score of zero, but my LDL-C is 500." You still may have a very big problem. And you should probably do something like the CT coronary angio, like the clearly CTI.”

“I've seen numerous people with calcium scores of zero who go do the CT angiogram and even get the clearly analysis. They still have zero calcification in the plaque, but they still have at least mild amount of soft plaque in the coronary arteries. So the risk is probably a little bit higher than they knew and so maybe they're going to be a little bit more aggressive with certain lifestyle modifications.”

“And in that case seems like you'd want to have a CT coronary angio to really fill in the data on like what's happening to your to your plaques and rather than being confused with the CAC.”

“I really need to do is get a CT coronary angiogram”

“but when it is zero doesn't change the fact that you live in a bad neighborhood and it doesn't change the fact that you can have lots of arterial damage that just hasn't shown up at the stage of calcification so you can have plenty of soft plaque that's still there without calcification that's still an enormous marker of risk and that doesn't get picked up with no”