Coronary Artery Calcium Scoring May Improve Use of Semaglutide for Heart Protection

PASADENA, Calif. — 2025 — A new editorial by Dr. Robert A. Kloner, Chief Science Officer and Scientific Director of Cardiovascular Research at Huntington Medical Research Institutes (HMRI), and Dr. Matthew Budoff of the Lundquist Institute, highlights how coronary artery calcium (CAC) scoring can refine the use of the GLP-1 receptor agonist semaglutide, best known for its roles in treating diabetes and obesity.

Published in JACC: Cardiovascular Imaging, the article — “Coronary Artery Calcium Scoring Improves Allocation of the GLP-1 Receptor Agonist Semaglutide” — examines emerging evidence from the MESA and SELECT studies showing that individuals with higher CAC scores derive greater cardiovascular benefit from semaglutide therapy.

The authors note that while semaglutide has proven effective in reducing heart attack and stroke risk, its high cost and limited availability make targeted use essential. Incorporating CAC scoring into clinical decision-making could help identify patients most likely to benefit — particularly those with elevated body mass index and CAC levels above 100 Agatston units.

“This study adds another powerful application to coronary calcium scoring,” said Dr. Kloner. “Beyond guiding statin or aspirin use, it can now help clinicians decide when GLP-1 therapies like semaglutide are most appropriate for cardiovascular prevention.”

The editorial builds on prior work showing that CAC scoring aids risk stratification for statins, aspirin, PCSK9 inhibitors, and blood pressure control — and extends the approach to a new class of cardiometabolic drugs.

Full article: JACC: Cardiovascular Imaging (2025)