Javaid A, Mitchell JD, Villines TC, et al. - Analyzing the performance of coronary artery calcium (CAC) in low‐risk younger adults, CAC was found prevalent in a large sample of such individuals. Significantly higher long‐term hazards of major adverse cardiovascular events (MACE) and myocardial infarction (MI) were observed in those with any CAC, while severe CAC raised hazards for all outcomes including death. CAC could be beneficial for clinical decision‐making among select young adults.

• A study of 13,397 patients aged 30 to 49 years without known cardiovascular disease or malignancy who were examined via CAC measurements.

• The estimated prevalence of any CAC was 20.6% in this cohort (74% men, mean age 44 years, and 76% with ≤1 cardiovascular disease risk factor).

• The relative adjusted subhazard ratio of CAC >0 was 2.9 and 1.6 for MI and for MACE, respectively, over a mean of 11 years of follow‐up.

• Significantly elevated hazards of MI (adjusted subhazard ratio, 5.2), MACE (3.1), stroke (1.7), and all‐cause mortality (hazard ratio, 2.1) were observed in relation to CAC >100.

• Significant improvement in the prognostic accuracy of risk factors for MACE, MI, and all‐cause mortality was afforded by CAC.