Necessity of Coronary CT Scans

To the Editor The Patient Page on coronary computed tomography (CT) scans paints a negative and incorrect picture.¹ The best answer to the question, “Should I get a coronary CT scan?” is that it depends.

We agree that patients should not take it upon themselves to obtain a coronary CT scan for the purposes of screening. This is consistent with scientific evidence and several independent guideline recommendations. However, as stated by the US Preventive Services Task Force (USPSTF), “adding a [coronary artery calcium] CAC score to existing [cardiovascular disease] CVD risk assessment models (eg, Framingham Risk Score) or Pooled Cohort Equations (PCE) may improve calibration, discrimination, and reclassification.”² Therefore, the statement that “Established risk calculators are more effective at estimating the risk of heart attack”¹ is incorrect.