ArticleAtherosclerosis2022
Coronary artery calcium scores indicating secondary prevention level risk: Findings from the CAC consortium and FOURIER trial.
Article in Atherosclerosis, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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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
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 47 citations in OpenAlex.
- Guideline
- Allocation of Semaglutide According to Coronary Artery Calcium and BMI: Applying the SELECT Trial to MESA.JACC. Cardiovascular imaging · 2025Trial
- Is there a role for measuring coronary artery calcium progression in 2026?American journal of preventive cardiology · 2026Article
- Risk prediction and prevention in patients with advanced subclinical atherosclerosis.BMC cardiovascular disorders · 2026Review
- Assessing Coronary Calcium Thresholds on Attenuation-Correction CT With Myocardial Perfusion Imaging Equating to Secondary Prevention.JACC. Advances · 2026Article
- Cardiovascular Prevention: Current Gaps and Future Directions.Diagnostics (Basel, Switzerland) · 2025Review
- Review
- Coronary Artery Calcium Scoring on Dedicated Cardiac CT and Noncardiac CT Scans.Radiology. Cardiothoracic imaging · 2025Review
- LDL-C targets based on coronary artery calcium: advancing Figure 6 from the 2022 American college of cardiology expert consensus decision pathway.American journal of preventive cardiology · 2025Article
- Why, how and in whom should we measure levels of lipoprotein(a): A review of the latest evidence and clinical implications.Diabetes, obesity & metabolism · 2025Review
- Inconsistent association between lipoprotein(a) and coronary artery calcium.European journal of preventive cardiology · 2025Article
- Article
- Reducing LDL-Cholesterol to Very Low Levels: Sailing Between Established Benefits and Potential Risks.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2025Review
- 2025 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association.Circulation · 2025Review
- When Does Primary Prevention Encroach on Secondary Prevention?Current atherosclerosis reports · 2024Review
- Subclinical Atherosclerosis to Guide Treatment in Dyslipidemia and Diabetes Mellitus.Current atherosclerosis reports · 2024Review
- Evolving Concepts of the SCORE System: Subtracting Cholesterol from Risk Estimation: A Way for a Healthy Longevity?Life (Basel, Switzerland) · 2024Review
- 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association.Circulation · 2024Review
- Coronary Artery Calcium Score as a Graded Decision Tool.JACC. Advances · 2023Article
- Evolving Management of Low-Density Lipoprotein Cholesterol: A Personalized Approach to Preventing Atherosclerotic Cardiovascular Disease Across the Risk Continuum.Journal of the American Heart Association · 2023Review
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Authors and funding
11 authors at 4 institutions in 2 countries.
Funding
Abstract
BACKGROUND AND
aimsCoronary artery calcium (CAC) burden displays a stepwise association with atherosclerotic cardiovascular disease (ASCVD) risk. Among primary prevention patients, we sought to determine the CAC scores equivalent to ASCVD mortality rates observed in the FOURIER trial, a modern secondary prevention cohort. METHODS AND
resultsFor the main analysis, we included participants from the CAC Consortium ≥50 years old with a 10-year ASCVD risk ≥7.5% (n = 20,207). Poisson regression was used to define the relationship between CAC and annual ASCVD mortality. Equations generated from the regression models were then used to derive CAC scores associated with equivalent annual ASCVD mortality as observed in FOURIER placebo participants from the overall trial and in key trial subgroups. The CAC Consortium participants had a similar age (65.5 versus 62.5 years) and sex (22% versus 24% female) distribution as FOURIER. The annualized ASCVD mortality rate in FOURIER participants (0.766 per 100 person-years) corresponded to a CAC score of 781 (418-1467). A CAC score of 255 (162-394) corresponded to an ASCVD mortality rate equivalent to the lowest risk FOURIER subgroup (presence of myocardial infarction >2 years prior to trial enrollment). No CAC score produced a risk equivalent to high-risk FOURIER subgroups, particularly those with symptomatic peripheral arterial disease and/or multivessel coronary heart disease.
conclusionsPrimary prevention individuals with increased CAC burden may have annualized ASCVD mortality rates equivalent to persons with stable secondary prevention-level risk. These findings argue for a risk continuum between higher risk primary prevention and stable secondary prevention patients, as their ASCVD risks may overlap.
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