: Recent advancements in cardiovascular imaging have opened new avenues for integrating novel biomarkers into risk assessment models, enhancing their predictive accuracy. One such emerging biomarker is the left atrioventricular coupling index (LACI). The study aims to evaluate the relationship between the SCORE (Systematic Coronary Risk Evaluation) and LACI derived from cardiac computed tomography (CCT). : This study included 137 participants (56.09 ± 7.64 years). Cardiovascular risk was assessed using the SCORE system. CCT was performed using the standard coronary computed tomography angiography protocol. LACI was calculated as the ratio of left atrial end-diastolic volume (LA EDV) to left ventricular end-diastolic volume (LV EDV), expressed as a percentage. : The subgroup with SCORE ≥5% had higher LACI than the subgroup with SCORE < 5%. Similarly, the subgroup with SCORE ≥10% had higher LACI than the subgroup with SCORE < 10%. LACI demonstrated a significant positive correlation with the SCORE (r = 0.29, = 0.01). Prediction analysis showed that LACI ≥ 53.34% as a predictor of SCORE ≥ 10% had the highest accuracy of 78.1%, with a high sensitivity of 79.8% and a moderate specificity of 61.5%. High specificity (80.6%) is characterized by LACI ≥ 29.52% as a predictor of SCORE ≥ 5. : LACI is a novel and significant biomarker associated with cardiovascular risk, as reflected by its relationship with the SCORE system.