ArticleJACC. Cardiovascular imaging2022
Mean Versus Peak Coronary Calcium Density on Non-Contrast CT: Calcium Scoring and ASCVD Risk Prediction.
Article in JACC. Cardiovascular imaging, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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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.
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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.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.
- Assessment of Subclinical Atherosclerosis in Asymptomatic People In Vivo: Measurements Suitable for Biomarker and Mendelian Randomization Studies.Arteriosclerosis, thrombosis, and vascular biology · 2024Pooled it
- Development and Validation of a Coronary Artery Calcium Volume and Density Score.Circulation. Cardiovascular imaging · 2026Article
- Opportunistic Assessment of Coronary Artery Calcium Volume and Density From Non-Electrocardiogram-Gated Chest CT Using Artificial Intelligence: Prognostic Implications in a Screening Cohort.Korean journal of radiology · 2026Article
- Coronary Artery Calcium Scoring on Dedicated Cardiac CT and Noncardiac CT Scans.Radiology. Cardiothoracic imaging · 2025Review
- Applicability of Effective Atomic Number (Zeff) Image Analysis of Coronary Plaques Measured With Photon- Counting Computed Tomography.Investigative radiology · 2025Article
- Beyond the Agatston calcium score: role of calcium density and other calcified plaque markers for cardiovascular disease prediction.Current opinion in cardiology · 2025Review
- Coronary artery calcium density progression: Should we measure it?Atherosclerosis · 2024Article
- CT-based radiomics nomogram to predict proliferative hepatocellular carcinoma and explore the tumor microenvironment.Journal of translational medicine · 2024Article
- Vascular Calcification Heterogeneity from Bench to Bedside: Implications for Manifestations, Pathogenesis, and Treatment Considerations.Aging and disease · 2024Review
- Relationship between the triglyceride-glucose index and coronary artery calcification in asymptomatic, non-diabetic patients undergoing maintenance hemodialysis.Renal failure · 2023Observational
- Cross-Sectional Validation of a Novel Computed Tomography-Based Carotid Mean Calcium Density Measurement.Journal of the American Heart Association · 2023Article
- Great debate: lipid-lowering therapies should be guided by vascular imaging rather than by circulating biomarkers.European heart journal · 2023Article
- Lower attenuation and higher kurtosis of coronary artery calcification associated with vulnerable plaque - an agatston score propensity-matched CT radiomics study.BMC cardiovascular disorders · 2023Article
- Coronary Artery Calcium Dispersion and Cause-Specific Mortality.The American journal of cardiology · 2023Article
- Coronary Artery Calcium Density and Cardiovascular Events by Volume Level: The MESA.Circulation. Cardiovascular imaging · 2023Article
- Coronary Artery Calcium Scoring in Asymptomatic Patients.HCA healthcare journal of medicine · 2023Review
- Discordance Between Coronary Artery Calcium Area and Density Predicts Long-Term Atherosclerotic Cardiovascular Disease Risk.JACC. Cardiovascular imaging · 2022Article
- Coronary artery calcium incidence and changes using direct plaque measurements: The MASALA study.Atherosclerosis · 2022Article
- Relationship BetweenAnnals of nuclear cardiology · 2022Article
- Explainable Machine-Learning Model to Classify Culprit Calcified Carotid Plaque in Embolic Stroke of Undetermined Source.Journal of neuroimaging : official journal of the American Society of NeuroimagingArticle
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Authors and funding
15 authors at 8 institutions in 2 countries.
Funding
Abstract
objectivesThis study sought to assess the relationship between mean vs peak calcified plaque density and their impact on calculating coronary artery calcium (CAC) scores and to compare the corresponding differential prediction of atherosclerotic cardiovascular disease (ASCVD) and coronary heart disease (CHD) mortality.
backgroundThe Agatston CAC score is quantified per lesion as the product of plaque area and a 4-level categorical peak calcium density factor. However, mean calcium density may more accurately measure the heterogenous mixture of lipid-rich, fibrous, and calcified plaque reflective of ASCVD risk.
methodsWe included 10,373 individuals from the CAC Consortium who had CAC >0 and per-vessel measurements of peak calcium density factor and mean calcium density. Area under the curve and continuous net reclassification improvement analyses were performed for CHD and ASCVD mortality to compare the predictive abilities of mean calcium density vs peak calcium density factor when calculating the Agatston CAC score.
resultsParticipants were on average 53.4 years of age, 24.4% were women, and the median CAC score was 68 Agatston units. The average values for mean calcium density and peak calcium density factor were 210 ± 50 HU and 3.1 ± 0.5, respectively. Individuals younger than 50 years of age and/or those with a total plaque area <100 mm
conclusionMean and peak calcium density may differentially describe plaque composition early in the atherosclerotic process. Mean calcium density performs better than peak calcium density factor when combined with plaque area for ASCVD mortality prediction among persons with Agatston CAC 1-99.
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