ArticleAtherosclerosis2021
Impact of clinical and subclinical coronary artery disease as assessed by coronary artery calcium in COVID-19.
Article in Atherosclerosis, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 41 citations in OpenAlex.
- Percutaneous Mechanical Circulatory Support Devices in Cardiogenic Shock: A Narrative Review in Light of Recent Evidence.Journal of clinical medicine · 2025Review
- SGLT2 inhibitors across the acute cardiac care spectrum: insights and perspectives.Future cardiology · 2025Review
- Erector Spinae Muscle to Epicardial Visceral Fat Ratio on Chest CT Predicts the Severity of Coronavirus Disease 2019.Journal of cachexia, sarcopenia and muscle · 2025Article
- Coronary artery calcification score as a prognostic indicator for COVID-19 mortality: evidence from a retrospective cohort study in Iran.Annals of medicine and surgery (2012) · 2024Article
- Chest CT opportunistic biomarkers for phenotyping high-risk COVID-19 patients: a retrospective multicentre study.European radiology · 2023Article
- CT coronary artery calcification score as a prognostic marker in COVID-19.Journal of thoracic disease · 2023Article
- Clinical utilization of artificial intelligence-based COVID-19 pneumonia quantification using chest computed tomography - a multicenter retrospective cohort study in Japan.Respiratory research · 2023Article
- Article
- Coronary calcium score in COVID-19 survivors: Association with cardiac injury and cardiac function after 6 weeks.American heart journal plus : cardiology research and practice · 2023Article
- Evaluation of COVID-19 vaccines in primary prevention against infections and reduction in severity of illness following the outbreak of SARS-CoV-2 omicron variant in Shanghai.Frontiers in medicine · 2023Article
- Advanced cardiac imaging in the spectrum of COVID-19 related cardiovascular involvement.Clinical imaging · 2022Review
- AI-SCoRE (artificial intelligence-SARS CoV2 risk evaluation): a fast, objective and fully automated platform to predict the outcome in COVID-19 patients.La Radiologia medica · 2022Article
- Impact of the "atherosclerotic pabulum" on in-hospital mortality for SARS-CoV-2 infection. Is calcium score able to identify at-risk patients?Clinical cardiology · 2022Article
- Lung Opacity and Coronary Artery Calcium Score: A Combined Tool for Risk Stratification and Outcome Prediction in COVID-19 Patients.Academic radiology · 2022Article
- Effect of Coronary Artery Disease on COVID-19-Prognosis and Risk Assessment: A Systematic Review and Meta-Analysis.Biology · 2022Article
- The hidden interplay between sex and COVID-19 mortality: the role of cardiovascular calcification.GeroScience · 2021Article
- Teaching an old dog new tricks: The prognostic role of CACS in hospitalized COVID-19 patients.Atherosclerosis · 2021Article
- Imaging Cardiovascular Inflammation in the COVID-19 Era.Diagnostics (Basel, Switzerland) · 2021Review
- Cross-National Variations in COVID-19 Mortality: The Role of Diet, Obesity and Depression.Diseases (Basel, Switzerland) · 2021Article
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Authors and funding
43 authors at 13 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsThe potential impact of coronary atherosclerosis, as detected by coronary artery calcium, on clinical outcomes in COVID-19 patients remains unsettled. We aimed to evaluate the prognostic impact of clinical and subclinical coronary artery disease (CAD), as assessed by coronary artery calcium score (CAC), in a large, unselected population of hospitalized COVID-19 patients undergoing non-gated chest computed tomography (CT) for clinical practice.
methodsSARS-CoV 2 positive patients from the multicenter (16 Italian hospitals), retrospective observational SCORE COVID-19 (calcium score for COVID-19 Risk Evaluation) registry were stratified in three groups: (a) "clinical CAD" (prior revascularization history), (b) "subclinical CAD" (CAC >0), (c) "No CAD" (CAC = 0). Primary endpoint was in-hospital mortality and the secondary endpoint was a composite of myocardial infarction and cerebrovascular accident (MI/CVA).
resultsAmongst 1625 patients (male 67.2%, median age 69 [interquartile range 58-77] years), 31%, 57.8% and 11.1% had no, subclinical and clinical CAD, respectively. Increasing rates of in-hospital mortality (11.3% vs. 27.3% vs. 39.8%, p < 0.001) and MI/CVA events (2.3% vs. 3.8% vs. 11.9%, p < 0.001) were observed for patients with no CAD vs. subclinical CAD vs clinical CAD, respectively. The association with in-hospital mortality was independent of in-study outcome predictors (age, peripheral artery disease, active cancer, hemoglobin, C-reactive protein, LDH, aerated lung volume): subclinical CAD vs. No CAD: adjusted hazard ratio (adj-HR) 2.86 (95% confidence interval [CI] 1.14-7.17, p=0.025); clinical CAD vs. No CAD: adj-HR 3.74 (95% CI 1.21-11.60, p=0.022). Among patients with subclinical CAD, increasing CAC burden was associated with higher rates of in-hospital mortality (20.5% vs. 27.9% vs. 38.7% for patients with CAC score thresholds≤100, 101-400 and > 400, respectively, p < 0.001). The adj-HR per 50 points increase in CAC score 1.007 (95%CI 1.001-1.013, p=0.016). Cardiovascular risk factors were not independent predictors of in-hospital mortality when CAD presence and extent were taken into account.
conclusionsThe presence and extent of CAD are associated with in-hospital mortality and MI/CVA among hospitalized patients with COVID-19 disease and they appear to be a better prognostic gauge as compared to a clinical cardiovascular risk assessment.
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