> Actually, yes guidelines are actually that any prior statin prescription removes the need for CAC measurements.

I mentioned that the CAC indication is for those in the 10-year ASCVD 5-20% risk band who are considering initiating a statin.

> I think the challenge here is that other than a CCTA there's no good way to estimate individual [...] risk

I'm not sure if you meant hereditary there, so I'll avoid the point.

Is this your area of medicine? I am not a specialist but I have never heard of cardiovascular risk stratification regarding primary prevention in the terms of impending risk to the individual except for NSTEMI patients getting a left-heart catheterization. So I would agree that CAC won't tell a patient when their MI will occur, but that's also true for CCTA and every other screening tool we have. They are designed to identify indviduals at high risk for more intensive preventive care.