When would you consider initiation of low-dose aspirin for primary prevention and/or statin therapy in patients with acceptable bleeding risk and evidence of coronary artery calcification on prior CT chest imaging?   

Several observational cohort studies show that persons with a CAC score >100 and who are at low bleeding risk, experience a net benefit with low-dose aspirin, with lower risk of MACE compared with bleeding. In the MESA study (Cainzos-Achirica and Nasir, PMID 32151147), among participants with a C...