Evidence map›Paper›PMID 28360032›Full record

ArticleCirculation2017

Multimodality Strategy for Cardiovascular Risk Assessment: Performance in 2 Population-Based Cohorts.

James A de Lemos, Colby R Ayers, Benjamin D Levine, Christopher R deFilippi, Thomas J Wang, W Gregory Hundley, Jarett D Berry, Stephen L Seliger, Darren K McGuire, Pamela Ouyang and 5 more

Open access · bronzeAbstract read
In one paragraph

Article in Circulation, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
57citing papers in PubMed, 4 pooled it
9.2field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

57 citing papers in PubMed, 4 syntheses or guidelines pooled it, 105 citations in OpenAlex.

  1. Pooled it
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  9. Periodontitis, subclinical myocardial injury, and cardiovascular mortality among US adults: a population-based study.Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 8 institutions in 1 country.

James A de LemosFrom Departments of Medicine (J.A.d.L., B.L., J.P.B., D.K.M., M.H.D., A.K.) and Clinical Sciences (C.R.A., J.D.B., D.K.M.), University of Texas Southwestern Medical Center, Dallas; Institute for Exercise and Environmental Medicine, Texas Health Presbyterian, Dallas (B.L.); Inova Heart and Vascular Institute, Fall Church, VA (C.R.d.); Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (T.J.W.); Departments of Medicine and Radiological Sciences, Wake Forest Health Sciences, Winston-Salem, NC (W.G.H.); Department of Medicine, University of Maryland School of Medicine, Baltimore (S.L.S.); The Johns Hopkins University School of Medicine, Baltimore, MD (P.O.); Los Angeles Biomedical Research Institute, CA (M.B.); Departments of Preventive Medicine and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (P.G.); and Baylor College of Medicine, Houston, TX (G.M.B.). james.delemos@utsouthwestern.edu.
Colby R AyersFrom Departments of Medicine (J.A.d.L., B.L., J.P.B., D.K.M., M.H.D., A.K.) and Clinical Sciences (C.R.A., J.D.B., D.K.M.), University of Texas Southwestern Medical Center, Dallas; Institute for Exercise and Environmental Medicine, Texas Health Presbyterian, Dallas (B.L.); Inova Heart and Vascular Institute, Fall Church, VA (C.R.d.); Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (T.J.W.); Departments of Medicine and Radiological Sciences, Wake Forest Health Sciences, Winston-Salem, NC (W.G.H.); Department of Medicine, University of Maryland School of Medicine, Baltimore (S.L.S.); The Johns Hopkins University School of Medicine, Baltimore, MD (P.O.); Los Angeles Biomedical Research Institute, CA (M.B.); Departments of Preventive Medicine and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (P.G.); and Baylor College of Medicine, Houston, TX (G.M.B.).
Benjamin D LevineFrom Departments of Medicine (J.A.d.L., B.L., J.P.B., D.K.M., M.H.D., A.K.) and Clinical Sciences (C.R.A., J.D.B., D.K.M.), University of Texas Southwestern Medical Center, Dallas; Institute for Exercise and Environmental Medicine, Texas Health Presbyterian, Dallas (B.L.); Inova Heart and Vascular Institute, Fall Church, VA (C.R.d.); Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (T.J.W.); Departments of Medicine and Radiological Sciences, Wake Forest Health Sciences, Winston-Salem, NC (W.G.H.); Department of Medicine, University of Maryland School of Medicine, Baltimore (S.L.S.); The Johns Hopkins University School of Medicine, Baltimore, MD (P.O.); Los Angeles Biomedical Research Institute, CA (M.B.); Departments of Preventive Medicine and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (P.G.); and Baylor College of Medicine, Houston, TX (G.M.B.).
Christopher R deFilippiFrom Departments of Medicine (J.A.d.L., B.L., J.P.B., D.K.M., M.H.D., A.K.) and Clinical Sciences (C.R.A., J.D.B., D.K.M.), University of Texas Southwestern Medical Center, Dallas; Institute for Exercise and Environmental Medicine, Texas Health Presbyterian, Dallas (B.L.); Inova Heart and Vascular Institute, Fall Church, VA (C.R.d.); Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (T.J.W.); Departments of Medicine and Radiological Sciences, Wake Forest Health Sciences, Winston-Salem, NC (W.G.H.); Department of Medicine, University of Maryland School of Medicine, Baltimore (S.L.S.); The Johns Hopkins University School of Medicine, Baltimore, MD (P.O.); Los Angeles Biomedical Research Institute, CA (M.B.); Departments of Preventive Medicine and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (P.G.); and Baylor College of Medicine, Houston, TX (G.M.B.).
Thomas J WangFrom Departments of Medicine (J.A.d.L., B.L., J.P.B., D.K.M., M.H.D., A.K.) and Clinical Sciences (C.R.A., J.D.B., D.K.M.), University of Texas Southwestern Medical Center, Dallas; Institute for Exercise and Environmental Medicine, Texas Health Presbyterian, Dallas (B.L.); Inova Heart and Vascular Institute, Fall Church, VA (C.R.d.); Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (T.J.W.); Departments of Medicine and Radiological Sciences, Wake Forest Health Sciences, Winston-Salem, NC (W.G.H.); Department of Medicine, University of Maryland School of Medicine, Baltimore (S.L.S.); The Johns Hopkins University School of Medicine, Baltimore, MD (P.O.); Los Angeles Biomedical Research Institute, CA (M.B.); Departments of Preventive Medicine and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (P.G.); and Baylor College of Medicine, Houston, TX (G.M.B.).
W Gregory HundleyFrom Departments of Medicine (J.A.d.L., B.L., J.P.B., D.K.M., M.H.D., A.K.) and Clinical Sciences (C.R.A., J.D.B., D.K.M.), University of Texas Southwestern Medical Center, Dallas; Institute for Exercise and Environmental Medicine, Texas Health Presbyterian, Dallas (B.L.); Inova Heart and Vascular Institute, Fall Church, VA (C.R.d.); Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (T.J.W.); Departments of Medicine and Radiological Sciences, Wake Forest Health Sciences, Winston-Salem, NC (W.G.H.); Department of Medicine, University of Maryland School of Medicine, Baltimore (S.L.S.); The Johns Hopkins University School of Medicine, Baltimore, MD (P.O.); Los Angeles Biomedical Research Institute, CA (M.B.); Departments of Preventive Medicine and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (P.G.); and Baylor College of Medicine, Houston, TX (G.M.B.).
Jarett D BerryFrom Departments of Medicine (J.A.d.L., B.L., J.P.B., D.K.M., M.H.D., A.K.) and Clinical Sciences (C.R.A., J.D.B., D.K.M.), University of Texas Southwestern Medical Center, Dallas; Institute for Exercise and Environmental Medicine, Texas Health Presbyterian, Dallas (B.L.); Inova Heart and Vascular Institute, Fall Church, VA (C.R.d.); Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (T.J.W.); Departments of Medicine and Radiological Sciences, Wake Forest Health Sciences, Winston-Salem, NC (W.G.H.); Department of Medicine, University of Maryland School of Medicine, Baltimore (S.L.S.); The Johns Hopkins University School of Medicine, Baltimore, MD (P.O.); Los Angeles Biomedical Research Institute, CA (M.B.); Departments of Preventive Medicine and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (P.G.); and Baylor College of Medicine, Houston, TX (G.M.B.).
Stephen L SeligerFrom Departments of Medicine (J.A.d.L., B.L., J.P.B., D.K.M., M.H.D., A.K.) and Clinical Sciences (C.R.A., J.D.B., D.K.M.), University of Texas Southwestern Medical Center, Dallas; Institute for Exercise and Environmental Medicine, Texas Health Presbyterian, Dallas (B.L.); Inova Heart and Vascular Institute, Fall Church, VA (C.R.d.); Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (T.J.W.); Departments of Medicine and Radiological Sciences, Wake Forest Health Sciences, Winston-Salem, NC (W.G.H.); Department of Medicine, University of Maryland School of Medicine, Baltimore (S.L.S.); The Johns Hopkins University School of Medicine, Baltimore, MD (P.O.); Los Angeles Biomedical Research Institute, CA (M.B.); Departments of Preventive Medicine and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (P.G.); and Baylor College of Medicine, Houston, TX (G.M.B.).
Darren K McGuireFrom Departments of Medicine (J.A.d.L., B.L., J.P.B., D.K.M., M.H.D., A.K.) and Clinical Sciences (C.R.A., J.D.B., D.K.M.), University of Texas Southwestern Medical Center, Dallas; Institute for Exercise and Environmental Medicine, Texas Health Presbyterian, Dallas (B.L.); Inova Heart and Vascular Institute, Fall Church, VA (C.R.d.); Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (T.J.W.); Departments of Medicine and Radiological Sciences, Wake Forest Health Sciences, Winston-Salem, NC (W.G.H.); Department of Medicine, University of Maryland School of Medicine, Baltimore (S.L.S.); The Johns Hopkins University School of Medicine, Baltimore, MD (P.O.); Los Angeles Biomedical Research Institute, CA (M.B.); Departments of Preventive Medicine and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (P.G.); and Baylor College of Medicine, Houston, TX (G.M.B.).
Pamela OuyangFrom Departments of Medicine (J.A.d.L., B.L., J.P.B., D.K.M., M.H.D., A.K.) and Clinical Sciences (C.R.A., J.D.B., D.K.M.), University of Texas Southwestern Medical Center, Dallas; Institute for Exercise and Environmental Medicine, Texas Health Presbyterian, Dallas (B.L.); Inova Heart and Vascular Institute, Fall Church, VA (C.R.d.); Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (T.J.W.); Departments of Medicine and Radiological Sciences, Wake Forest Health Sciences, Winston-Salem, NC (W.G.H.); Department of Medicine, University of Maryland School of Medicine, Baltimore (S.L.S.); The Johns Hopkins University School of Medicine, Baltimore, MD (P.O.); Los Angeles Biomedical Research Institute, CA (M.B.); Departments of Preventive Medicine and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (P.G.); and Baylor College of Medicine, Houston, TX (G.M.B.).
Mark H DraznerFrom Departments of Medicine (J.A.d.L., B.L., J.P.B., D.K.M., M.H.D., A.K.) and Clinical Sciences (C.R.A., J.D.B., D.K.M.), University of Texas Southwestern Medical Center, Dallas; Institute for Exercise and Environmental Medicine, Texas Health Presbyterian, Dallas (B.L.); Inova Heart and Vascular Institute, Fall Church, VA (C.R.d.); Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (T.J.W.); Departments of Medicine and Radiological Sciences, Wake Forest Health Sciences, Winston-Salem, NC (W.G.H.); Department of Medicine, University of Maryland School of Medicine, Baltimore (S.L.S.); The Johns Hopkins University School of Medicine, Baltimore, MD (P.O.); Los Angeles Biomedical Research Institute, CA (M.B.); Departments of Preventive Medicine and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (P.G.); and Baylor College of Medicine, Houston, TX (G.M.B.).
Matthew BudoffFrom Departments of Medicine (J.A.d.L., B.L., J.P.B., D.K.M., M.H.D., A.K.) and Clinical Sciences (C.R.A., J.D.B., D.K.M.), University of Texas Southwestern Medical Center, Dallas; Institute for Exercise and Environmental Medicine, Texas Health Presbyterian, Dallas (B.L.); Inova Heart and Vascular Institute, Fall Church, VA (C.R.d.); Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (T.J.W.); Departments of Medicine and Radiological Sciences, Wake Forest Health Sciences, Winston-Salem, NC (W.G.H.); Department of Medicine, University of Maryland School of Medicine, Baltimore (S.L.S.); The Johns Hopkins University School of Medicine, Baltimore, MD (P.O.); Los Angeles Biomedical Research Institute, CA (M.B.); Departments of Preventive Medicine and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (P.G.); and Baylor College of Medicine, Houston, TX (G.M.B.).
Philip GreenlandFrom Departments of Medicine (J.A.d.L., B.L., J.P.B., D.K.M., M.H.D., A.K.) and Clinical Sciences (C.R.A., J.D.B., D.K.M.), University of Texas Southwestern Medical Center, Dallas; Institute for Exercise and Environmental Medicine, Texas Health Presbyterian, Dallas (B.L.); Inova Heart and Vascular Institute, Fall Church, VA (C.R.d.); Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (T.J.W.); Departments of Medicine and Radiological Sciences, Wake Forest Health Sciences, Winston-Salem, NC (W.G.H.); Department of Medicine, University of Maryland School of Medicine, Baltimore (S.L.S.); The Johns Hopkins University School of Medicine, Baltimore, MD (P.O.); Los Angeles Biomedical Research Institute, CA (M.B.); Departments of Preventive Medicine and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (P.G.); and Baylor College of Medicine, Houston, TX (G.M.B.).
Christie M BallantyneFrom Departments of Medicine (J.A.d.L., B.L., J.P.B., D.K.M., M.H.D., A.K.) and Clinical Sciences (C.R.A., J.D.B., D.K.M.), University of Texas Southwestern Medical Center, Dallas; Institute for Exercise and Environmental Medicine, Texas Health Presbyterian, Dallas (B.L.); Inova Heart and Vascular Institute, Fall Church, VA (C.R.d.); Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (T.J.W.); Departments of Medicine and Radiological Sciences, Wake Forest Health Sciences, Winston-Salem, NC (W.G.H.); Department of Medicine, University of Maryland School of Medicine, Baltimore (S.L.S.); The Johns Hopkins University School of Medicine, Baltimore, MD (P.O.); Los Angeles Biomedical Research Institute, CA (M.B.); Departments of Preventive Medicine and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (P.G.); and Baylor College of Medicine, Houston, TX (G.M.B.).
Amit KheraFrom Departments of Medicine (J.A.d.L., B.L., J.P.B., D.K.M., M.H.D., A.K.) and Clinical Sciences (C.R.A., J.D.B., D.K.M.), University of Texas Southwestern Medical Center, Dallas; Institute for Exercise and Environmental Medicine, Texas Health Presbyterian, Dallas (B.L.); Inova Heart and Vascular Institute, Fall Church, VA (C.R.d.); Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (T.J.W.); Departments of Medicine and Radiological Sciences, Wake Forest Health Sciences, Winston-Salem, NC (W.G.H.); Department of Medicine, University of Maryland School of Medicine, Baltimore (S.L.S.); The Johns Hopkins University School of Medicine, Baltimore, MD (P.O.); Los Angeles Biomedical Research Institute, CA (M.B.); Departments of Preventive Medicine and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (P.G.); and Baylor College of Medicine, Houston, TX (G.M.B.).
Institute for Exercise and Environmental Medicine · USJohns Hopkins University · USJohns Hopkins Medicine · USNorthwestern University · USWake Forest University · USAlaska Heart and Vascular Institute · USUniversity of Maryland, Baltimore · USVanderbilt University Medical Center · US

Funding

UT Southwestern Center for Translational Medicine (UL1/KL2/TL1)UL1TR001105 · NCATS · UT SOUTHWESTERN MEDICAL CENTER · PI TOTO, ROBERT DANIEL · 2013 to 2017
$24.5M
North and Central Texas Clinical and Translational Science Initiative (KL2)KL2RR024983 · NCRR · UT SOUTHWESTERN MEDICAL CENTER · PI TOTO, ROBERT DANIEL · 2007 to 2011
$4.3M
UT Southwestern Center for Translational Medicine (UL1/KL2/TL1KL2TR001103 · NCATS · UT SOUTHWESTERN MEDICAL CENTER · PI TOTO, ROBERT DANIEL · 2013 to 2017
$4.0M
Ventricular Size and Valve Calcification Measures by CTR01HL071739 · NHLBI · LUNDQUIST INSTITUTE FOR BIOMEDICAL INNOVATION AT HARBOR-UCLA MEDICAL CENTER · PI BUDOFF, MATTHEW J · 2003 to 2010
$2.0M
Cigarette Smoke and Susceptibility to Influenza InfectionR01HL095163 · NHLBI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI JASPERS, ILONA, NOAH, TERRY L · 2009 to 2013
$2.0M
SUBCLINICAL CARDIOVASCULAR DISEASE STUDY-FIELD CENTERN01HC095162 · HC · JOHNS HOPKINS UNIVERSITY · PI SZKLO, MOYSES A · 1999 to 2000
$694k
SUBCLINICAL CARDIOVASCULAR DISEASE STUDY--FIELD CENTERN01HC095161 · HC · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI SHEA, STEVEN · 1999 to 2001
$642k
SUBCLINICAL CARDIOVASCULAR DISEASE STUDY--FIELD CENTERN01HC095165 · HC · WAKE FOREST UNIVERSITY · PI BURKE, GREGORY L · 1999 to 2001
$616k
SUBCLINICAL CARDIOVASCULAR DISEASE STUDY--FIELD CENTERN01HC095160 · HC · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI SAAD, MOHAMMED F · 1999 to 2001
$592k
SUBCLINICAL CARDIOVASCULAR DISEASE STUDY-FIELD CENTERN01HC095164 · HC · NORTHWESTERN UNIVERSITY · PI LIU, KIANG JOHN · 1999 to 2001
$511k
SUBCLINICAL CARDIOVASCULAR DISEASE STUDY--FIELD CENTERN01HC095163 · HC · UNIVERSITY OF MINNESOTA TWIN CITIES · PI FOLSOM, AARON R · 1999 to 2001
$443k
Enhancing immune reconstitution after implantation of postnatal allogeneic thymusR21HL095165 · NHLBI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI CROOKS, GAY M · 2008 to 2009
$440k
NCATS NIH HHS KL2 TR001103NCATS NIH HHS UL1 TR001105NCRR NIH HHS KL2 RR024983NHLBI NIH HHS N01 HC095159NHLBI NIH HHS N01 HC095160NHLBI NIH HHS N01 HC095161NHLBI NIH HHS N01 HC095162NHLBI NIH HHS N01 HC095163NHLBI NIH HHS N01 HC095164NHLBI NIH HHS N01 HC095165NHLBI NIH HHS N01 HC095169NHLBI NIH HHS R01 HL071739
6 · The paper itself

Abstract

backgroundCurrent strategies for cardiovascular disease (CVD) risk assessment among adults without known CVD are limited by suboptimal performance and a narrow focus on only atherosclerotic CVD (ASCVD). We hypothesized that a strategy combining promising biomarkers across multiple different testing modalities would improve global and atherosclerotic CVD risk assessment among individuals without known CVD.

methodsWe included participants from MESA (Multi-Ethnic Study of Atherosclerosis) (n=6621) and the Dallas Heart Study (n=2202) who were free from CVD and underwent measurement of left ventricular hypertrophy by ECG, coronary artery calcium, N-terminal pro B-type natriuretic peptide, high-sensitivity cardiac troponin T, and high-sensitivity C-reactive protein. Associations of test results with the global composite CVD outcome (CVD death, myocardial infarction, stroke, coronary or peripheral revascularization, incident heart failure, or atrial fibrillation) and ASCVD (fatal or nonfatal myocardial infarction or stroke) were assessed over >10 years of follow-up. Multivariable analyses for the primary global CVD end point adjusted for traditional risk factors plus statin use and creatinine (base model).

resultsEach test result was independently associated with global composite CVD events in MESA after adjustment for the components of the base model and the other test results (

conclusionsAmong adults without known CVD, a novel multimodality testing strategy using left ventricular hypertrophy by ECG, coronary artery calcium, N-terminal pro B-type natriuretic peptide, high-sensitivity cardiac troponin T, and high-sensitivity C-reactive protein significantly improved global CVD and ASCVD risk assessment.

Indexed as

EthnicityPopulation SurveillanceAdultAgedBiomarkersCardiovascular DiseasesCohort StudiesCombined Modality TherapyElectrocardiographyFemaleFollow-Up StudiesHumansMaleMiddle AgedProspective StudiesRisk AssessmentBiomarkersbiomarkercoronary calciumC-reactive proteinNT-proBNPrisk predictiontroponin T

Identifiers

PMID28360032
PMCPMC5486874
OpenAlexW2599627323

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

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.