Adding coronary CT angiography (CCTA) data to traditional risk scores and coronary artery calcium scoring improved risk prediction for first coronary events over nearly 8 years of follow-up.

While the clinical impact was modest in a low-risk population, CCTA enhanced risk discrimination and reclassification, particularly among those considered low risk by conventional models.

This cohort study assesses whether coronary computed tomography angiography improves risk prediction beyond traditional risk factors and coronary artery calcium score in identifying individuals at risk of first coronary events.