FYI on ct coronary artery calcium score:
Small point about coronary artery calcium scoring. The test does not claim to localized specific sites of stenosis/narrowing. Conventional coronary angiography and possibly ct coronary angiography actually demonstrate regions of stenosis.
The coronary artery calcium score is a test measuring "plaque burden" and therefore is a marker of disease and indicates that further treatment or tests are warranted.
Also, it is estimated that over half of myocardial infarctions arise in arteries that are not critically narrowed. The current theory suggests an abrupt thrombosis (clot) within a diseased but not narrowed artery that develops when fatty/lipid plaque erodes and is directly exposed to the blood. The lipid incites a clotting cascade which clogs the artery and then kills the downstream heart muscle.
That's one reason why a baby aspirin every other day helps prevent heart attacks and strokes.
Where did you find that practice guideline?