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Please see the Editorial Comment by Jeffrey M. Levsky discussing this article.

BACKGROUND. Current guidelines recommend visual evaluation of coronary artery calcium (CAC) on all nongated noncontrast chest CT examinations. However, chest CT examinations are often performed with contrast material administration.

OBJECTIVE. The purpose of our study was to evaluate diagnostic performance, prognostic utility, and interobserver agreement of visual CAC assessment on chest CT performed for other indications.

METHODS. This retrospective study included 260 patients (158 men, 102 women; mean age, 60 ± 11 [SD] years) who underwent both nongated chest CT (contrast-enhanced in 116 patients; noncontrast in 144 patients) and cardiac calcium score CT within a 12-month interval. A cardiothoracic radiologist visually assessed CAC on chest CT using an ordinal scale (absent, mild, moderate, or severe …