Evidence map›Paper›PMID 29142010›Full record

Trial reportCirculation2018

Value of Progression of Coronary Artery Calcification for Risk Prediction of Coronary and Cardiovascular Events: Result of the HNR Study (Heinz Nixdorf Recall).

Nils Lehmann, Raimund Erbel, Amir A Mahabadi, Michael Rauwolf, Stefan Möhlenkamp, Susanne Moebus, Hagen Kälsch, Thomas Budde, Axel Schmermund, Andreas Stang and 6 more

Registry-linked trialAbstract readClinical TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Circulation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03655704 (Apabetalone for Pulmonary Arterial Hypertension), which is not on this map. Cited by 109 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
109citing papers in PubMed, 3 pooled it
–field-weighted citation impact
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.

NCT03655704 early_phase1completednot on this mapstarted 2019, after this paper: background citation

Apabetalone for Pulmonary Arterial Hypertension: a Pilot Study

TypeinterventionalSponsorSteeve ProvencherRan2019 to 2021Enrolled7ConditionsPulmonary Arterial HypertensionArmsApabetalone
3 · Its place in the literature

Who cites it

109 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. The effect of Vitamin-KJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2022
    Trial
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  8. Observational
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  10. Review
  11. Observational
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  19. Evaluation of coronary artery calcium score by age and sex: a multicenter study.The international journal of cardiovascular imaging · 2025
    Article
  20. Review

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

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors.

Nils LehmannInstitute for Medical Informatics, Biometry and Epidemiology, University Duisburg-Essen, Germany (N.L. R.E., S. Moebus, A.S., U.R., K.-H.J.) nils.lehmann@uk-essen.de.
Raimund ErbelInstitute for Medical Informatics, Biometry and Epidemiology, University Duisburg-Essen, Germany (N.L. R.E., S. Moebus, A.S., U.R., K.-H.J.).
Amir A MahabadiDepartment of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen (A.A.M.).
Michael RauwolfDepartment of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen (A.A.M.).
Stefan MöhlenkampClinic of Cardiology, Bethanien Hospital, Moers, Germany (S. Möhlenkamp).
Susanne MoebusInstitute for Medical Informatics, Biometry and Epidemiology, University Duisburg-Essen, Germany (N.L. R.E., S. Moebus, A.S., U.R., K.-H.J.).
Hagen KälschAlfried-Krupp Hospital, Essen, Germany (H.K., T.B.).
Thomas BuddeAlfried-Krupp Hospital, Essen, Germany (H.K., T.B.).
Axel SchmermundInstitute for Medical Informatics, Biometry and Epidemiology, University Duisburg-Essen, Germany (N.L. R.E., S. Moebus, A.S., U.R., K.-H.J.).
Andreas StangDepartment of Epidemiology, School of Public Health, Boston University, MA (A. Stang).
Dagmar Führer-SakelInstitute of Clinical Chemistry and Laboratory Medicine, University Duisburg-Essen, Germany (D.F.-S.).
Christian WeimarUniversity Clinic of Neurology, University Duisburg-Essen, Germany (C.W.).
Ulla RoggenbuckInstitute for Medical Informatics, Biometry and Epidemiology, University Duisburg-Essen, Germany (N.L. R.E., S. Moebus, A.S., U.R., K.-H.J.).
Nico DraganoInstitute of Medical Sociology, Medical Faculty, University Düsseldorf, Germany (N.D.).
Karl-Heinz JöckelInstitute for Medical Informatics, Biometry and Epidemiology, University Duisburg-Essen, Germany (N.L. R.E., S. Moebus, A.S., U.R., K.-H.J.).
Heinz Nixdorf Recall Study Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundComputed tomography (CT) allows estimation of coronary artery calcium (CAC) progression. We evaluated several progression algorithms in our unselected, population-based cohort for risk prediction of coronary and cardiovascular events.

methodsIn 3281 participants (45-74 years of age), free from cardiovascular disease until the second visit, risk factors, and CTs at baseline (b) and after a mean of 5.1 years (5y) were measured. Hard coronary and cardiovascular events, and total cardiovascular events including revascularization, as well, were recorded during a follow-up time of 7.8±2.2 years after the second CT. The added predictive value of 10 CAC progression algorithms on top of risk factors including baseline CAC was evaluated by using survival analysis, C-statistics, net reclassification improvement, and integrated discrimination index. A subgroup analysis of risk in CAC categories was performed.

resultsWe observed 85 (2.6%) hard coronary, 161 (4.9%) hard cardiovascular, and 241 (7.3%) total cardiovascular events. Absolute CAC progression was higher with versus without subsequent coronary events (median, 115 [Q1-Q3, 23-360] versus 8 [0-83],

conclusionsCAC progression is associated with coronary and cardiovascular event rates, but adds only weakly to risk prediction. What counts is the most recent CAC value and risk factor assessment. Therefore, a repeat scan >5 years after the first scan may be of additional value, except when a double-zero CT scan is present or when the subjects are already at high risk.

Indexed as

AlgorithmsCoronary Artery DiseaseTomography, X-Ray ComputedAgedDisease-Free SurvivalFemaleFollow-Up StudiesHumansMaleMiddle AgedRisk FactorsSurvival RateVascular Calcificationatherosclerosiscoronary diseasedisease progressionrisk assessmenttomographyvascular calcification

Identifiers

PMID29142010
PMCPMC5811240

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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.