Observational studyEuropean heart journal2014
Impact of coronary artery calcium on coronary heart disease events in individuals at the extremes of traditional risk factor burden: the Multi-Ethnic Study of Atherosclerosis.
Observational study in European heart journal, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 122 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
122 citing papers in PubMed, 1 synthesis or guideline pooled it, 300 citations in OpenAlex.
- Coronary artery calcium and primary prevention risk assessment: what is the evidence? An updated meta-analysis on patient and physician behavior.Circulation. Cardiovascular quality and outcomes · 2012Pooled it
- Polygenic Risk Based Detection and Treatment of Subclinical Coronary Atherosclerosis in the PROACT Clinical Trials.Journal of the American College of Cardiology · 2026Trial
- Predictors of long-term absence of coronary artery calcium in individuals with high blood pressure: results from the MESA study.Annals of medicine · 2023Trial
- Cardiac calcium score on 2D echo: correlations with cardiac and coronary calcium at multi-detector computed tomography.Cardiovascular ultrasound · 2014Trial
- Ischemic Risk in Patients with Zero Coronary Artery Calcium Undergoing Stress PET/CT Testing.Journal of clinical medicine · 2026Article
- Development of Mathematical Models Evaluating Presence of Coronary Calcification Independent of Computed Tomography (DEPICT): Radiation-Free Evaluation of Coronary Atherosclerosis.Reviews in cardiovascular medicine · 2026Article
- IntestinalJournal of clinical and translational hepatology · 2026Article
- Insulin resistance assessed by estimated glucose disposal rate and risk of coronary artery calcification in middle-aged participants without diabetes undergoing health check-ups.Frontiers in endocrinology · 2026Article
- Association of monocyte to high-density lipoprotein cholesterol ratio with non-calcified plaques in subclinical coronary atherosclerosis: a cross-sectional study in hypertensive patients.Frontiers in endocrinology · 2026Article
- Review
- Role of Coronary Artery Calcium Score CT in Risk Stratification of Asymptomatic Individuals.Journal of cardiovascular development and disease · 2025Review
- Interplay of glycated hemoglobin and traditional risk factors for the risk of atherosclerotic cardiovascular disease and all-cause mortality in people without diabetes.Cardiovascular diabetology · 2025Observational
- Detection of subclinical atherosclerosis by image-based deep learning on chest X-ray.European heart journal. Digital health · 2025Article
- Associations of HLA-DRB1 shared epitope alleles with cardiovascular disease and events in a multi-ethnic community-living population: The multi-ethnic study of atherosclerosis (MESA).Human immunology · 2025Article
- Bridging Prevention and Imaging: The Influence of Statins on CAC and CCTA Findings.Current atherosclerosis reports · 2025Review
- Alterations in the autonomic and haemodynamic response to prolonged high-intensity endurance exercise in individuals with coronary artery calcification.Experimental physiology · 2025Article
- 2025 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association.Circulation · 2025Review
- Feasibility analysis of non-electrocardiogram-triggered chest low-dose computed tomography using a kV-independent reconstruction algorithm for predicting cardiovascular disease risk in patients receiving maintenance hemodialysis.BMC cardiovascular disorders · 2025Article
- Mapping clinical and imaging factors that might predict cardiac events in breast cancer patients.Frontiers in oncology · 2025Article
- Prognostic importance of extensive coronary calcium on lung cancer screening chest computed tomography.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2024Article
62 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 8 institutions in 1 country.
Funding
Abstract
aimsWe sought to evaluate the impact of coronary artery calcium (CAC) in individuals at the extremes of risk factor (RF) burden. METHODS AND
results6698 individuals from the Multi-Ethnic Study of Atherosclerosis (MESA) were followed for coronary heart disease (CHD) events over mean 7.1 ± 1 years. Annualized CHD event rates were compared among each RF category (0, 1, 2, or ≥3) after stratification by CAC score (0, 1-100, 101-300, and >300). The following traditional modifiable RFs were considered: cigarette smoking, LDL cholesterol ≥3.4 mmol/L, low HDL cholesterol, hypertension, and diabetes. There were 1067 subjects (16%) with 0 RFs, whereas 1205 (18%) had ≥3 RFs. Among individuals with 0 RFs, 68% had CAC 0, whereas 12 and 5% had CAC >100 and >300, respectively. Among individuals with ≥3 RFs, 35% had CAC 0, whereas 34 and 19% had CAC >100 and >300, respectively. Overall, 339 (5.1%) CHD events occurred. Individuals with 0 RFs and CAC >300 had an event rate 3.5 times higher than individuals with ≥3 RFs and CAC 0 (10.9/1000 vs. 3.1/1000 person-years). Similar results were seen across categories of Framingham risk score.
conclusionAmong individuals at the extremes of RF burden, the distribution of CAC is heterogeneous. The presence of a high CAC burden, even among individuals without RFs, is associated with an elevated event rate, whereas the absence of CAC, even among those with many RF, is associated with a low event rate. Coronary artery calcium has the potential to further risk stratify asymptomatic individuals at the extremes of RF burden.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.