Case presentation: -Male. -63 y.o. - Knee osteoarthritis limiting exercise capacity. - Hypertension (BP 145/90 mmHg under medication). - Family history of CAD (father had sudden death at 53). - Total Cholesterol = 223; HDL = 45; LDL = 128, Gluc = 0.97. Teaching points - CAC provides independent incremental information in addition to traditional risk factors in the prediction of allcause mortality. - The principal difference between MPS and Ca scoring is that the former is an excellent tool for assessing shortterm risk, guiding decisions on revascularization.? - In contrast, atherosclerosis imaging methods like CAC provide greater long-term risk assessment, and are more useful in defining the need for aggressive medical prevention.