Risicoverfijning in het tijdperk van een CAC-score van nul: de meerwaarde van fitheid

In this issue of Atherosclerosis, Griffin et al. [1] tackle a key challenge in cardiovascular risk stratification: shifting the focus from static imaging to functional capacity to identify risk in the large population of patients with a zero coronary artery calcification (CAC) score. The authors conducted a cross-sectional analysis of 2322 middle-aged participants from the Swedish CArdioPulmonary bioImage Study (SCAPIS) who had a CAC score of zero. They measured (or, more accurately, estimated) cardiorespiratory fitness (CRF) using a submaximal cycle test and, crucially, used coronary computed tomography angiography (CCTA) to detect the presence of any atherosclerosis.