ASCVD indicates atherosclerotic cardiovascular disease; CAC, coronary artery calcium; LDL-C, low-density lipoprotein cholesterol; and PCE, pooled cohort equations. CLINICAL STATEMENTS AND GUIDELINES benefit cannot be discounted.S4.4.2-53 The same holds for CAC score of zero and a high 10 year risk (eg, 20%).S4.4.2-34 For those with CAC scores of 1 to 99 Agatston units, 10-year ASCVD event rates are 3.8%, 6.5%, and 8.3% for age groups sug- gesting that CAC scores in this range favor statin initiation only in adults >55 years of age and indi- cating that risk reclassification is modest for indi- viduals with CAC scores of 1 to 99. Therefore, for patients with CAC scores of 1 to 99, it is reasonable to repeat the risk discussion. If these patients remain untreated, repeat CAC measure- ment in 5 to 10 years may have some value in reassessing for CAC progression, but data are A systematic review and meta-analysis suggests that knowledge that a patient s CAC score is greater than zero is Selected examples of candidates for CAC scoring who might benefit from know- ing that their CAC score is zero are listed in Table 8. There is an increased likelihood that lifestyle therapies and drug therapy will be started or con- tinued with significant, albeit modest, changes in risk factor levels and predicted risk levels. 8. Clinicians may need to address reducing ASCVD risk in higher-risk primary-prevention patients who either do not wish to take a statin or can- not tolerate the recommended intensity of statin therapy. In such patients, it may be reasonable to use LDL-C lowering drugs that have been proven safe and effective in RCTs, either as monotherapy or combined with a statin.S4.4.2-9 One alternative is a cholesterol absorption inhibitor. 