Clinical/methodical issue: Radiologic imaging for the assessment of individual cardiovascular risk.
Standard radiological methods: The correct estimation of the individual cardiovascular risk is prerequisite for the prevention of cardiovascular diseases. Here, extensive evidence is available for coronary calcium scans as well as coronary CT angiography (CTA).
Methodical innovations: Summary of the available evidence for the use of calcium score and coronary CTA. Illustration of the significance of both tests in current guidelines.
Performance: Both tests have high prognostic value, surpassing a risk-factor based assessment. In comparison with the calcium score, the CTA has higher incremental value.
Achievements: Results from recent trials confirm an improvement of outcomes in symptomatic patients by performing a CTA compared with standard care.
Practical recommendations: European and US guidelines recommend a calcium score for risk stratification of asymptomatic patients with a low to intermediate risk profile. For symptomatic patients with low to intermediate coronary artery disease pretest probability, a CTA is recommended.
Keywords: Atherosclerosis; Computed tomography angiography; Coronary artery disease; Coronary stenosis; Risk assessment.