The Power Greater Than Zero: Leveraging Incidental Vascular Calcification to Prevent Major Adverse Cardiovascular Events

Authors

• Michael Riddle, University of LynchburgFollow

Specialty

Orthopedics

Advisor

Dr. Lawrence Herman

Abstract

ABSTRACT

Cardiovascular disease (CVD) remains the leading cause of death globally. A critical implementation gap exists in the diagnosis and management of subclinical coronary artery disease (CAD). Incidental vascular calcification in asymptomatic patients with no prior cardiac history is often dismissed as an age-related change. In the context of CAD, a subclinical plaque burden is often missed by standard risk models and by interpretations of screening tests. The Riddle Power of Greater-Than-Zero (PGTZ) Protocol, consisting of a Prescriptive Reporting Model guide for radiologists and a 5-Stage Action Model Algorithm for clinicians, addresses this gap. It establishes a framework in which an incidental finding of a non-zero calcium burden serves as a clinical trigger for a proactive cardiac workup. It provides a viable clinical pathway to transition from population-level risk estimation to the proactive identification of established subclinical CAD and luminal burden. This review examines the clinical rationale for the PGTZ framework and its potential to displace CAD from its position as the leading cause of global mortality through a proactive approach of identification, quantification, stratification, and aggressive intervention.

Recommended Citation

Riddle M. The Power Greater Than Zero: Leveraging Incidental Vascular Calcification to Prevent Major Adverse Cardiovascular Events. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2026; 8(1).