Observational studyEuropean heart journal. Cardiovascular Imaging2017
Prevalence of obstructive coronary artery disease and prognosis in patients with stable symptoms and a zero-coronary calcium score.
Observational study in European heart journal. Cardiovascular Imaging, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04151121 (Mindfulness Based Intervention in Patients With Persistent Pain in Chest), which is not on this map. Cited by 42 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.
Mindfulness Based Intervention in Patients With Persistent Pain in Chest (MIPIC) of Non-Cardiac Cause - a Feasibility Randomised Control Study
Who cites it
42 citing papers in PubMed, 81 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
- Mindfulness-based intervention in patients with persistent pain in chest (MIPIC) of non-cardiac cause: a feasibility randomised control study.Open heart · 2022Trial
- Ischemic Risk in Patients with Zero Coronary Artery Calcium Undergoing Stress PET/CT Testing.Journal of clinical medicine · 2026Article
- Utilizing the coronary artery calcium score to predict coronary artery disease in individuals with presumed cardiac symptoms: A diagnostic study.American heart journal plus : cardiology research and practice · 2026Article
- Does Sex or Age Impact the Prognostic Value of a Zero Coronary Artery Calcium Score?Journal of clinical medicine · 2025Article
- A LASSO-based predictive nomogram for obstructive coronary artery disease in double zero score patients: validation and cardiovascular education strategies.Frontiers in cardiovascular medicine · 2025Article
- Combining anatomical and biochemical markers in the detection and risk stratification of coronary artery disease.European heart journal. Cardiovascular Imaging · 2024Article
- Article
- Efficacy of Coronary Calcium Score in Predicting Coronary Artery Morphology in Patients With Obstructive Coronary Artery Disease.Journal of the Society for Cardiovascular Angiography & Interventions · 2024Article
- Comparison of the RF-CL and CACS-CL models to estimate the pretest probability of obstructive coronary artery disease and predict prognosis in patients with stable chest pain and diabetes mellitus.Frontiers in cardiovascular medicine · 2024Article
- Diagnostic utility of coronary artery calcium score percentiles and categories to exclude abnormal scans and relevant ischemia in rubidium positron emission tomography.Frontiers in cardiovascular medicine · 2024Article
- The incremental value of coronary artery calcium score in predicting long-term prognosis and defining the warranty period of normal adenosine stress-only myocardial perfusion imaging using CZT SPECT.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- The power of zero calcium in 82-Rubidium PET irrespective of sex and age.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- MicroRNA-361-5p acts as a biomarker for carotid artery stenosis and promotes vascular smooth muscle cell proliferation and migration.BMC medical genomics · 2023Article
- The impact of coronary calcium score as an addition to myocardial perfusion imaging in altering clinical management (ICCAMPA trial).Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- Transient ischaemic dilation ratio thresholds in patients with zero coronary calcium score undergoing exercise or dipyridamole stress SPECT myocardial perfusion imaging using a cadmium-zinc-telluride camera.European heart journal. Imaging methods and practice · 2023Article
- 2023 Guidelines of the Taiwan Society of Cardiology on the Diagnosis and Management of Chronic Coronary Syndrome.Acta Cardiologica Sinica · 2023Article
- Article
- Preventive cardiology advances in the 2021 AHA/ACC chest pain guideline.American journal of preventive cardiology · 2022Article
- An update on the coronary calcium score: a review for clinicians.Postepy w kardiologii interwencyjnej = Advances in interventional cardiology · 2022Review
Corrections and comments
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Authors and funding
19 authors at 9 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsCT calcium scoring (CTCS) and CT cardiac angiography (CTCA) are widely used in patients with stable chest pain to exclude significant coronary artery disease (CAD). We aimed to resolve uncertainty about the prevalence of obstructive coronary artery disease and long-term outcomes in patients with a zero-calcium score (ZCS). METHODS AND
resultsConsecutive patients with stable cardiac symptoms referred for CTCS or CTCS and CTCA from chest pain clinics to a tertiary cardiothoracic centre were prospectively enrolled. In those with a ZCS, the prevalence of obstructive CAD on CTCA was determined. A follow-up for all-cause mortality was obtained from the NHS tracer service. A total of 3914 patients underwent CTCS of whom 2730 (69.7%) also had a CTCA. Half of the patients were men (50.3%) with a mean age of 56.9 years. Among patients who had both procedures, a ZCS was present in 52.2%, with a negative predictive value of 99.5% for excluding ≥70% stenosis on CTCA. During a mean follow-up of 5.2 years, the annual event rate was 0.3% for those with ZCS compared with 1.2% for CS ≥1. The presence of non-calcified atheroma on CTCA in patients with ZCS did not affect the prognostic value (P = 0.98).
conclusionIn patients with stable symptoms and a ZCS, obstructive CAD is rare, and prognosis over the long-term is excellent, regardless of whether non-calcified atheroma is identified. A ZCS could reliably be used as a 'gatekeeper' in this patient cohort, obviating the need for further more expensive tests.
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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.