Primary prevention of cardiovascular disease simplified: which variables best predict relevant coronary calcification?

Risk prediction of future heart attack or stroke in seemingly healthy individuals as currently done is not very accurate. A simple CT-scan of the heart is able to identify calcifications in the coronary arteries (CAC) and has proven to be the best predictor of both heart attacks and stroke, independent of risk factors and is even better in identifying true low risk if CACs 0. We propose to redesign risk evaluation for the general population by using a simple first screening tool followed by CT CACS. We would like to use the data of Lifelines to be able to build this simple model that bests predicts early signs of CAC. With this method a better precision of individuals at risk and with true low risk is given and health care costs can be reduced by preventing unnecessary treatments and follow-up medical care.