Evidence map›Paper›PMID 28797402›Full record

SynthesisJACC. Cardiovascular imaging2017

The Identification of Calcified Coronary Plaque Is Associated With Initiation and Continuation of Pharmacological and Lifestyle Preventive Therapies: A Systematic Review and Meta-Analysis.

Ankur Gupta, Emily Lau, Ravi Varshney, Edward A Hulten, Michael Cheezum, Marcio S Bittencourt, Michael J Blaha, Nathan D Wong, Roger S Blumenthal, Matthew J Budoff and 3 more

Open access · greenAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in JACC. Cardiovascular imaging, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
70citing papers in PubMed, 4 pooled it
12.8field-weighted citation impact, top 1% 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

70 citing papers in PubMed, 4 syntheses or guidelines pooled it, 164 citations in OpenAlex.

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10 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 5 institutions in 2 countries.

Ankur GuptaCardiovascular Imaging Program, Division of Cardiovascular Medicine and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Emily LauCardiovascular Imaging Program, Division of Cardiovascular Medicine and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Ravi VarshneyCardiovascular Imaging Program, Division of Cardiovascular Medicine and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Edward A HultenCardiovascular Imaging Program, Division of Cardiovascular Medicine and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Walter Reed National Military Medical Center, Washington, DC.
Michael CheezumCardiovascular Imaging Program, Division of Cardiovascular Medicine and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Fort Belvoir Community Hospital, Fort Belvoir, Virginia.
Marcio S BittencourtCardiovascular Imaging Program, Division of Cardiovascular Medicine and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Center for Clinical and Epidemiological Research, University Hospital, University of Sao Paulo, Sao Paulo, Brazil; Hospital Israelita Albert Einstein and Faculdade Israelita de Ciencias da Saude Albert Einstein, Sao Paulo, Brazil.
Michael J BlahaJohn Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland.
Nathan D WongUniversity of California, Irvine, Irvine, California.
Roger S BlumenthalJohn Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland.
Matthew J BudoffHarbor-University of California at Los Angeles, Torrance, California.
Craig A UmscheidPenn Medicine, Philadelphia, Pennsylvania.
Khurram NasirJohn Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland; Baptist Health South Florida, Miami, Florida.
Ron BlanksteinCardiovascular Imaging Program, Division of Cardiovascular Medicine and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: rblankstein@bwh.harvard.edu.
Brigham and Women's Hospital · USBaptist Hospital of Miami · USPenn Center for AIDS Research · USUniversity of California, Irvine · USUniversity of California, Los Angeles · US

Funding

Noninvasive Cardiovascular Imaging Research Training ProgramT32HL094301 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI Marcelo F DI CARLI · 2010 to 2026
$7.8M
NHLBI NIH HHS T32 HL094301
6 · The paper itself

Abstract

objectivesThe aim of this study was to assess the odds of initiation or continuation of pharmacological and lifestyle preventive therapies in patients with nonzero versus zero coronary artery calcium (CAC) score detected on cardiac computed tomography.

backgroundDetection of calcified coronary plaque could serve as a motivational tool for physicians and patients to intensify preventive therapies.

methodsWe searched PubMed, EMBASE (Excerpta Medica database), Web of Science, Cochrane CENTRAL (Cochrane central register of controlled trials), ClinicalTrials.gov, and the International Clinical Trials Registry Platform for studies evaluating the association of CAC scores with downstream pharmacological or lifestyle interventions for prevention of cardiovascular disease. Pooled odds ratios (ORs) of downstream interventions were obtained using the DerSimonian and Laird random effects model.

resultsAfter a review of 6,256 citations and 54 full-text papers, 6 studies (11,256 participants, mean follow-up time: 1.6 to 6.0 years) were included. Pooled estimates of the odds of aspirin initiation (OR: 2.6; 95% confidence interval [CI]: 1.8 to 3.8), lipid-lowering medication initiation (OR: 2.9; 95% CI: 1.9 to 4.4), blood pressure-lowering medication initiation (OR: 1.9; 95% CI: 1.6 to 2.3), lipid-lowering medication continuation (OR: 2.3; 95% CI: 1.6 to 3.3), increase in exercise (OR: 1.8; 95% CI: 1.4 to 2.4), and dietary change (OR: 1.9; 95% CI: 1.5 to 2.5) were higher in individuals with nonzero CAC versus zero CAC scores, but not for aspirin or blood pressure-lowering medication continuation. When assessed within individual studies, these findings remained significant after adjustment for baseline patient characteristics and cardiovascular risk factors.

conclusionsThis systematic review and meta-analysis suggests that nonzero CAC score, identifying calcified coronary plaque, significantly increases the likelihood of initiation or continuation of pharmacological and lifestyle therapies for the prevention of cardiovascular disease.

Indexed as

Coronary AngiographyPlaque, AtheroscleroticRisk Reduction BehaviorAdultAttitude of Health PersonnelCardiovascular AgentsChi-Square DistributionCoronary Artery DiseaseCoronary VesselsFemaleHealth Knowledge, Attitudes, PracticeHumansLinear ModelsMaleMiddle AgedOdds RatioCardiovascular Agentscardiovascular preventioncoronary calcium scoremeta-analysis

Identifiers

PMID28797402
PMCPMC5761651
OpenAlexW2744593153

What OpenQuestion holds

Textmetadata
LicenceTDM
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.