Comparing predictive risk to actual presence of coronary atherosclerosis on coronary computed tomography angiography

There is limited data showing the predictive accuracy of traditional cardiovascular risk scores (CVRS) to predict asymptomatic coronary artery disease (CAD) determined by coronary computed tomography angiography (CCTA). Asymptomatic individuals without known CAD undergoing a screening CCTA and sufficient data to calculate their CVRS, were extracted retrospectively. Atherosclerosis was extracted using natural language processing of the CCTA report, including the coronary artery calcium score (CACS) and the extent and severity of CAD. Absence of atherosclerosis was defined as both zero plaque and zero CACS, and atherosclerosis was defined as low, moderate, or extensive by location and extent of plaque-burden. CVRS was categorized as high (>15 %), moderate (10–15 %), low (1–9 %) and “zero” (