Download Full Text (547 KB)

Document Type



• Atherosclerotic cardiovascular disease (ASCVD) is highly prevalent in today’s society and contributes to high rates of mortality involved with heart disease.

• The initial assessment of ASCVD and risk stratification concerning the development of an acute coronary event can be performed in a number of ways.

• Current American Heart Association (AHA) guidelines recommend exercise stress testing (ETT) as the initial, noninvasive evaluation of choice.

• However, the accuracy of this test is highly dependent on the patient’s endurance, body mass index, and artifact, making analyzation difficult.

• Non-contrast cardiac computed tomography (CT) with coronary artery calcium (CAC) scoring has been shown to be specific and sensitive, however only recommended for further evaluation post ETT, those with insignificant stress test findings, and those unable to exercise.

• The purpose of this study is to determine if CAC scoring is a more useful predictor of ASCVD and acute coronary events compared to exercise stress testing.

• The review of literature compares accuracy, predictability, and cost of ETT versus CAC scoring. • The results display high sensitivity using CAC as the initial diagnostic test in patients

determined as low to intermediate risk for an acute coronary event without significant increase in cost.

• The findings may be used to justify current guidelines or propose alterations to certain patient populations as to which test would be more accurate and cost-effective in the risk stratification of ASCVD.


Physician Assistant Studies

Degree Name

Master of Physician Assistant Studies (MPAS)

First Advisor

Jay Metzger

Publication Date



Coronary Disease -- diagnostic imaging; Exercise Test; Comparative Study


Cardiovascular Diseases

Coronary Artery Calcium Scoring vs. Exercise Tolerance Testing: Diagnoses and Risk Stratification of ASCVD