Observational studyJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2014
Prognostic significance of calcified plaque among symptomatic patients with nonobstructive coronary artery disease.
Observational study in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 32 citations in OpenAlex.
- Association of coronary artery calcium score with qualitatively and quantitatively assessed adverse plaque on coronary CT angiography in the SCOT-HEART trial.European heart journal. Cardiovascular Imaging · 2022Trial
- Trial
- Coronary Artery Plaque Characteristics Associated With Adverse Outcomes in the SCOT-HEART Study.Journal of the American College of Cardiology · 2019 · on this mapTrial
- Differences of plaque burden measures on CCTA in younger men and women.American journal of preventive cardiology · 2026Article
- Article
- The Diagnostic and Prognostic Value of Coronary Calcium Scoring in Stable Chest Pain Patients: A Narrative Review.RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin · 2022Review
- Anatomy and physiology in coronary artery disease imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2019Article
- Imaging Cardiovascular Calcification.Journal of the American Heart Association · 2018Review
- Higher coronary artery calcification score is associated with adverse prognosis in patients with stable angina pectoris.Journal of thoracic disease · 2017Article
- Noninvasive Imaging to Evaluate Women With Stable Ischemic Heart Disease.JACC. Cardiovascular imaging · 2016Review
- CML/RAGE signal induces calcification cascade in diabetes.Diabetology & metabolic syndrome · 2016Article
- Effect of Dipeptidyl Peptidase-4 Inhibitor on All-Cause Mortality and Coronary Revascularization in Diabetic Patients.Journal of cardiovascular ultrasound · 2015Article
- Emergence of Nonobstructive Coronary Artery Disease: A Woman's Problem and Need for Change in Definition on Angiography.Journal of the American College of Cardiology · 2015Review
- Exploring the nature of atheroma and cardiovascular inflammation in vivo using positron emission tomography (PET).The British journal of radiology · 2015Review
- Review of cardiovascular imaging in The Journal of Nuclear Cardiology in 2014: Part 1 of 2: Positron emission tomography, computed tomography, and neuronal imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2015Review
- Screening for asymptomatic coronary heart disease in the young 'at risk' population: Who and how?International journal of cardiology. Heart & vasculature · 2015Review
- The evolving role of coronary computed tomography in understanding sex differences in coronary atherosclerosis.Journal of cardiovascular computed tomographyReview
- Noninvasive Evaluation of Symptomatic Women with Suspected Coronary Artery Disease.Methodist DeBakey cardiovascular journalReview
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Authors and funding
29 authors at 19 institutions in 7 countries.
Funding
Abstract
backgroundCoronary artery calcium (CAC) is a well-established predictor of clinical outcomes for population screening. Limited evidence is available as to its predictive value in symptomatic patients without obstructive coronary artery disease (CAD). The aim of the current study was to assess the prognostic value of CAC scores among symptomatic patients with nonobstructive CAD.
methodsFrom the COronary Computed Tomographic Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter (CONFIRM) registry, 7,200 symptomatic patients with nonobstructive CAD (<50% coronary stenosis) on coronary-computed tomographic angiography were prospectively enrolled and followed for a median of 2.1 years. Patients were categorized as without (0% stenosis) or with (>0% but <50% coronary stenosis) a luminal stenosis. CAC scores were calculated using the Agatston method. Univariable and multivariable Cox proportional hazard models were employed to estimate all-cause mortality and/or myocardial infarction (MI). Four-year death and death or MI rates were 1.9% and 3.3%.
resultsOf the 4,380 patients with no luminal stenosis, 86% had CAC scores of <10 while those with a luminal stenosis had more prevalent and extensive CAC with 31.9% having a CAC score of ≥100. Among patients with no luminal stenosis, CAC was not predictive of all-cause mortality (P = .44). However, among patients with a luminal stenosis, 4-year mortality rates ranged from 0.8% to 9.8% for CAC scores of 0 to ≥400 (P < .0001). The mortality hazard was 6.0 (P = .004) and 13.3 (P < .0001) for patients with a CAC score of 100-399 and ≥400. In patients with a luminal stenosis, CAC remained independently predictive in all-cause mortality (P < .0001) and death or MI (P < .0001) in multivariable models containing CAD risk factors and presenting symptoms.
conclusionsCAC allows for the identification of those at an increased hazard for death or MI in symptomatic patients with nonobstructive disease. From the CONFIRM registry, the extent of CAC was an independent estimator of long-term prognosis among symptomatic patients with luminal stenosis and may further define risk and guide preventive strategies in patients with nonobstructive CAD.
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