Evidence map›Paper›PMID 34327479›Full record

ArticleAmerican journal of preventive cardiology2020

Association between coronary artery calcium and cardiovascular disease as a supporting cause in cancer: The CAC consortium.

Frances M Wang, Cara Reiter-Brennan, Zeina Dardari, Catherine H Marshall, Khurram Nasir, Michael D Miedema, Daniel S Berman, Alan Rozanski, John A Rumberger, Matthew J Budoff and 2 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of preventive cardiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 15% 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

10 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 8 institutions in 2 countries.

Frances M WangJohns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University, Baltimore, MD, USA.
Cara Reiter-BrennanJohns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University, Baltimore, MD, USA.
Zeina DardariJohns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University, Baltimore, MD, USA.
Catherine H MarshallSidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA.
Khurram NasirDivision Cardiovascular Prevention and Wellness, Houston Methodist Hospital, Houston, TX, USA.
Michael D MiedemaMinneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, MN, USA.
Daniel S BermanDepartment of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Alan RozanskiDivision of Cardiology, Mount Sinai St. Luke's Hospital, New York, NY, USA.
John A RumbergerPrinceton Longevity Center, Princeton, NJ, USA.
Matthew J BudoffDepartment of Medicine, Harbor-UCLA Medical Center, University of California Los Angeles, Los Angeles, CA, USA.
Omar DzayeJohns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University, Baltimore, MD, USA.
Michael J BlahaJohns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University, Baltimore, MD, USA.
Johns Hopkins University · USAbbott Northwestern Hospital · USCedars-Sinai Medical Center · USHouston Methodist · USPrinceton University · USSidney Kimmel Comprehensive Cancer Center · USSt. Luke's Hospital · USUniversity of California, Los Angeles · US

Funding

CARDIOVASCULAR EPIDEMIOLOGY INSTITUTIONAL TRAININGT32HL007024 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI Elizabeth Selvin · 1985 to 2026
$17.5M
NHLBI NIH HHS L30 HL110027NHLBI NIH HHS T32 HL007024
6 · The paper itself

Abstract

backgroundIdentifying cancer patients at high risk of CVD is important for targeting CVD prevention strategies and evaluating chemotherapy options in the context of cardiotoxicity. Coronary artery calcium (CAC), a strong marker of coronary atherosclerosis, is used clinically to enhance risk assessment, yet the value of CAC for assessing risk of CVD complications in cancer is poorly understood.

objectiveIn cases of cancer mortality, to determine the value of CAC for predicting risk of CVD as a supporting cause of death.

methodsThe CAC Consortium is a multi-center cohort of 66,636 asymptomatic adults without CVD who underwent CAC scanning. During a follow-up of 12.5 years, 1129 patients died of cancer and were included in this analysis. The primary outcome was presence of CVD listed as a supporting cause of cancer mortality on official death certificates obtained from the National Death Index. Logistic regression models were used to assess the odds of CVD being listed as a supporting cause of death by CAC.

resultsCVD was listed as a supporting cause of death in 306 (27%) cancer mortality cases. Baseline CAC was significantly higher in individuals with CVD-supported mortality. Odds ratios of having CVD-supported death increased by ASCVD risk score category [1.15 (0.81, 1.65) for 5-20% 10-year risk and 1.97 (1.36, 2.89) for ≥20% risk, in reference to <5% 10-year ASCVD risk] and CAC category [1.07 (0.73, 1.57) for CAC 1-99, 1.29 (0.87, 1.93) for CAC 100-399, and 2.14 (1.48, 3.09) for CAC ≥400 relative to CAC 0]. In the CAC ≥400 group, these associations remained significantly elevated after adjustment for traditional CVD risk factors [1.66 (1.08, 2.55)]. A sensitivity analysis using a more specific ASCVD-supported mortality outcome, defined as coronary heart disease, stroke, and peripheral artery disease, demonstrated that adjusted odds of ASCVD-supported cancer mortality were significantly elevated in the CAC ≥400 group relative to CAC 0 [3.09 (1.39, 7.38)].

conclusionsIn cancer mortality cases, high antecedent CAC predicted risk of having CVD as a supporting cause of death on official death certificates, independently of ASCVD risk score and CVD risk factors. CAC may be useful for identifying cancer patients at high CVD risk who might benefit from more intense preventive cardiovascular therapies.

Indexed as

BiomarkerCancerCardiac imagingCoronary artery calcium

Identifiers

PMID34327479
PMCPMC8315471
OpenAlexW3101878440

What OpenQuestion holds

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LicenceCC BY-NC-ND
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.