NZCR-MESA Score May Guide CT Protocols by Predicting Coronary Calcification

A retrospective study of 241 Caucasian patients undergoing CCTA at a German center found that the non-zero-calcification-risk nzcr-MESA score moderately tracks coronary artery calcification and CAD-RADS severity (CAC: women r=0.56, men r=0.39; CAD-RADS: women r=0.45, men r=0.42). The score could help preselect imaging protocols, with sex-specific cutoffs around 90–95% and a combined 95%, routing about 73% to the appropriate protocol and reducing unnecessary ultra-high-resolution scans. AUCs for predicting severe CAC were 0.66–0.74. Limitations include single-center, Caucasian-only sampling and potential selection bias. Published online July 17, 2026 in European Journal of Radiology.