Shea S, Navas-Acien A, Shimbo D, et al. - Researchers assessed spatially weighted coronary calcium score (SWCS), an alternative scoring method for coronary artery calcium (CAC) that assigns scores to persons with Agatston CAC=0, to ascertain its predictive validity for incident coronary heart disease (CHD) events. A baseline exam from 2000 to 2002 in 6,814 participants including computed tomography scanning for CAC was performed in MESA (Multi-Ethnic Study of Atherosclerosis). Experts conducted subsequent assessments and systematic follow-up of the cohort for results. Among individuals with Agatston CAC score=0, incident CHD events were shown to be predicted by SWCS. Also, SWCS enabled the prediction of conversion to Agatston CAC > 0 at repeat computed tomography scanning at later exams. Findings demonstrated the predictive validity of SWCS as a subclinical phenotype and marker of CHD risk in people with Agatston CAC=0.