Observational studyEuropean heart journal2014
Progression of coronary artery calcification seems to be inevitable, but predictable - results of the Heinz Nixdorf Recall (HNR) study.
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 48 papers.
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
48 citing papers in PubMed, 94 citations in OpenAlex.
- Value of Progression of Coronary Artery Calcification for Risk Prediction of Coronary and Cardiovascular Events: Result of the HNR Study (Heinz Nixdorf Recall).Circulation · 2018Trial
- Hyperphosphatemia and hs-CRP Initiate the Coronary Artery Calcification in Peritoneal Dialysis Patients.BioMed research international · 2017Trial
- Review
- Distribution, extent, and calculated age of initiation of coronary artery calcification.Polish journal of radiology · 2026Article
- Hypercholesterolemia Is the Only Risk Factor Consistently Associated with Coronary Calcification in Three European Countries-Euro CCAD Study.Diagnostics (Basel, Switzerland) · 2025Article
- Validation of the Nepalese Version of the Quality of Recovery-15 Questionnaire in Patients Undergoing Elective Surgery.JNMA; journal of the Nepal Medical Association · 2025Observational
- Coronary artery calcium in a 20-year-old South Asian patient - pushing the limits of detecting "early disease".American journal of preventive cardiology · 2025Article
- Progression of arterial calcifications: what, where, and in whom?European radiology · 2024Article
- Beyond Stress Ischemia: Unveiling the Multifaceted Nature of Coronary Vulnerable Plaques Using Cardiac Computed Tomography.Journal of clinical medicine · 2024Review
- Re-Evaluation of Cardiovascular Disease Risk and Primary Prevention Treatments with Coronary Artery Calcium Scoring in Primary Prevention Patients.Journal of clinical medicine · 2024Article
- Ten-year trajectory of coronary artery calcification and risk of cardiovascular outcomes: the Multi-Ethnic Study of Atherosclerosis.Frontiers in cardiovascular medicine · 2024Article
- The "Coming of Age" of Coronary Calcium Score?Arquivos brasileiros de cardiologia · 2023Article
- Vascular ageing: moving from bench towards bedside.European journal of preventive cardiology · 2023Article
- Diagnostic Cardiac CT for the Improvement of Cardiovascular Event Prediction.Deutsches Arzteblatt international · 2023Article
- High- vs. Low-Intensity Statin Therapy and Changes in Coronary Artery Calcification Density after One Year.Journal of clinical medicine · 2023Article
- Artificial intelligence in coronary computed tomography angiography: Demands and solutions from a clinical perspective.Frontiers in cardiovascular medicine · 2023Review
- Glycemic control is independently associated with rapid progression of coronary atherosclerosis in the absence of a baseline coronary plaque burden: a retrospective case-control study from the PARADIGM registry.Cardiovascular diabetology · 2022Article
- Distribution of Coronary Artery Calcium by Age, Sex, and Race Among Patients 30-45 Years Old.Journal of the American College of Cardiology · 2022Article
- Effect of glycemic control on markers of subclinical atherosclerosis in patients with type 2 diabetes mellitus: A review.World journal of diabetes · 2021Review
- Per- and polyfluoroalkyl substances and calcifications of the coronary and aortic arteries in adults with prediabetes: Results from the diabetes prevention program outcomes study.Environment international · 2021Article
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Authors and funding
19 authors at 7 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimCoronary artery calcification (CAC), as a sign of atherosclerosis, can be detected and progression quantified using computed tomography (CT). We develop a tool for predicting CAC progression. METHODS AND
resultsIn 3481 participants (45-74 years, 53.1% women) CAC percentiles at baseline (CACb) and after five years (CAC₅y) were evaluated, demonstrating progression along gender-specific percentiles, which showed exponentially shaped age-dependence. Using quantile regression on the log-scale (log(CACb+1)) we developed a tool to individually predict CAC₅y, and compared to observed CAC₅y. The difference between observed and predicted CAC₅y (log-scale, mean±SD) was 0.08±1.11 and 0.06±1.29 in men and women. Agreement reached a kappa-value of 0.746 (95% confidence interval: 0.732-0.760) and concordance correlation (log-scale) of 0.886 (0.879-0.893). Explained variance of observed by predicted log(CAC₅y+1) was 80.1% and 72.0% in men and women, and 81.0 and 73.6% including baseline risk factors. Evaluating the tool in 1940 individuals with CACb>0 and CACb<400 at baseline, of whom 242 (12.5%) developed CAC₅y>400, yielded a sensitivity of 59.5%, specificity 96.1%, (+) and (-) predictive values of 68.3% and 94.3%. A pre-defined acceptance range around predicted CAC₅y contained 68.1% of observed CAC₅y; only 20% were expected by chance. Age, blood pressure, lipid-lowering medication, diabetes, and smoking contributed to progression above the acceptance range in men and, excepting age, in women.
conclusionCAC nearly inevitably progresses with limited influence of cardiovascular risk factors. This allowed the development of a mathematical tool for prediction of individual CAC progression, enabling anticipation of the age when CAC thresholds of high risk are reached.
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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.