Evidence map›Paper›PMID 31784032›Full record

ArticleAtherosclerosis2020

All-cause and cause-specific mortality in individuals with zero and minimal coronary artery calcium: A long-term, competing risk analysis in the Coronary Artery Calcium Consortium.

Michael J Blaha, Miguel Cainzos-Achirica, Zeina Dardari, Ron Blankstein, Leslee J Shaw, Alan Rozanski, John A Rumberger, Omar Dzaye, Erin D Michos, Daniel S Berman and 4 more

Open access · greenAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Atherosclerosis, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
44citing papers in PubMed, 1 pooled it
5.0field-weighted citation impact, top 4% 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

44 citing papers in PubMed, 1 synthesis or guideline pooled it, 81 citations in OpenAlex.

  1. Atherosclerosis after pre-eclampsia: systematic review and meta-analysis.Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology · 2026
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 8 institutions in 1 country.

Michael J BlahaCiccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. Electronic address: mblaha1@jhmi.edu.
Miguel Cainzos-AchiricaCiccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA. Electronic address: mcainzos@jhu.edu.
Zeina DardariCiccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Ron BlanksteinCardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Leslee J ShawWeill Cornell Medical College, New York, NY, USA.
Alan RozanskiDivision of Cardiology, Mount Sinai St. Luke's Hospital, New York, NY, USA.
John A RumbergerPrinceton Longevity Center, Princeton, NJ, USA.
Omar DzayeCiccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Erin D MichosCiccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Daniel S BermanDepartment of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Matthew J BudoffDepartment of Medicine, Harbor-UCLA Medical Center, Los Angeles, CA, USA.
Michael D MiedemaMinneapolis Heart Institute and Foundation, Minneapolis, MN, USA.
Roger S BlumenthalCiccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Khurram NasirCiccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA; Yale School of Medicine, New Haven, CT, USA.
Johns Hopkins University · USBrigham and Women's Hospital · USCedars-Sinai Medical Center · USCornell University · USHarbor–UCLA Medical Center · USMinneapolis Heart Institute Foundation · USPrinceton University · USSt. Luke's Hospital · US

Funding

NHLBI NIH HHS L30 HL110027
6 · The paper itself

Abstract

BACKGROUND AND

aimsThe long-term associations between zero, minimal coronary artery calcium (CAC) and cause-specific mortality are currently unknown, particularly after accounting for competing risks with other causes of death.

methodsWe evaluated 66,363 individuals from the CAC Consortium (mean age 54 years, 33% women), a multi-center, retrospective cohort study of asymptomatic individuals undergoing CAC scoring for clinical risk assessment. Baseline evaluations occurred between 1991 and 2010.

resultsOver a mean of 12 years of follow-up, individuals with CAC = 0 (45% prevalence, mean age 45 years) had stable low rates of coronary heart disease (CHD) death, cardiovascular disease (CVD) death (ranging 0.32 to 0.43 per 1000 person-years), and all-cause death (1.38-1.62 per 1000 person-years). Cancer was the predominant cause of death in this group, yet rates were also very low (0.47-0.79 per 1000 person-years). Compared to CAC = 0, individuals with CAC 1-10 had an increased multivariable-adjusted risk of CVD death only under age 40. Individuals with CAC>10 had multivariable-adjusted increased risks of CHD death, CVD death and all-cause death at all ages, and a higher proportion of CVD deaths.

conclusionsCAC = 0 is a frequent finding among individuals undergoing CAC scanning for risk assessment and is associated with low rates of all-cause death at 12 years of follow-up. Our results support the emerging consensus that CAC = 0 represents a unique population with favorable all-cause prognosis who may be considered for more flexible treatment goals in primary prevention. Detection of any CAC in young adults could be used to trigger aggressive preventive interventions.

Indexed as

AgedCoronary Artery DiseaseFemaleHumansMaleMiddle AgedPrevalenceRetrospective StudiesRisk AssessmentSeverity of Illness IndexSurvival RateVascular CalcificationCancerCardiovascular diseaseCompeting risksCoronary artery calciumMortalityRisk

Identifiers

PMID31784032
PMCPMC7012761
OpenAlexW2985510041

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.