Evidence map›Paper›PMID 35370113›Full record

ArticleJACC. Cardiovascular imaging2022

Coronary Artery Calcium for Risk Stratification of Sudden Cardiac Death: The Coronary Artery Calcium Consortium.

Alexander C Razavi, S M Iftekhar Uddin, Zeina A Dardari, Daniel S Berman, Matthew J Budoff, Michael D Miedema, Albert D Osei, Olufunmilayo H Obisesan, Khurram Nasir, Alan Rozanski and 7 more

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

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 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
3.3field-weighted citation impact, top 8% 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

12 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Review
  5. Article
  6. Article
  7. Article
  8. Article
  9. Review
  10. Subclinical Hypertension-Mediated Organ Damage (HMOD) in Hypertension: Atherosclerotic Cardiovascular Disease (ASCVD) and Calcium Score.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2023
    Review
  11. Review
  12. Observational
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors at 9 institutions in 2 countries.

Alexander C RazaviJohns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Emory Center for Heart Disease Prevention, Emory University School of Medicine, Atlanta, Georgia, USA.
S M Iftekhar UddinJohns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Zeina A DardariJohns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Daniel S BermanDepartment of Imaging, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Matthew J BudoffLundquist Institute, Harbor-UCLA Medical Center, Torrance, California, USA.
Michael D MiedemaMinneapolis Heart Institute and Foundation, Minneapolis, Minnesota, USA.
Albert D OseiJohns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Olufunmilayo H ObisesanJohns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Khurram NasirDivision of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA.
Alan RozanskiDivision of Cardiology, Mount Sinai, St Luke's Hospital, New York, New York, USA.
John A RumbergerDepartment of Cardiac Imaging, Princeton Longevity Center, Princeton, New Jersey, USA.
Leslee J ShawDepartment of Radiology, Weill Cornell Medicine, New York, New York, USA.
Laurence S SperlingEmory Center for Heart Disease Prevention, Emory University School of Medicine, Atlanta, Georgia, USA.
Seamus P WheltonJohns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Martin Bødtker MortensenJohns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
Michael J BlahaJohns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Omar DzayeJohns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. Electronic address: odzaye@jhmi.edu.
Johns Hopkins University · USCedars-Sinai Medical Center · USCornell University · USEmory University · USHouston Methodist · USMinneapolis Heart Institute Foundation · USPrinceton University · USSt. Luke's Hospital · USUCLA Medical Center · US

Funding

PATHOPHYSIOLOGY OF MYOCARDIAL DISEASEST32HL007227 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI Chulan Kwon, WENDY S POST · 1985 to 2026
$21.2M
NHLBI NIH HHS L30 HL110027NHLBI NIH HHS T32 HL007227
6 · The paper itself

Abstract

backgroundCoronary artery calcium (CAC) is a marker of plaque burden. Whether CAC improves risk stratification for incident sudden cardiac death (SCD) beyond atherosclerotic cardiovascular disease (ASCVD) risk factors is unknown.

objectivesSCD is a common initial manifestation of coronary heart disease (CHD); however, SCD risk prediction remains elusive.

methodsThe authors studied 66,636 primary prevention patients from the CAC Consortium. Multivariable competing risks regression and C-statistics were used to assess the association between CAC and SCD, adjusting for demographics and traditional risk factors.

resultsThe mean age was 54.4 years, 33% were women, 11% were of non-White ethnicity, and 55% had CAC >0. A total of 211 SCD events (0.3%) were observed during a median follow-up of 10.6 years, 91% occurring among those with baseline CAC >0. Compared with CAC = 0, there was a stepwise higher risk (P trend < 0.001) in SCD for CAC 100 to 399 (subdistribution hazard ratio [SHR]: 2.8; 95% CI: 1.6-5.0), CAC 400 to 999 (SHR: 4.0; 95% CI: 2.2-7.3), and CAC >1,000 (SHR: 4.9; 95% CI: 2.6-9.9). CAC provided incremental improvements in the C-statistic for the prediction of SCD among individuals with a 10-year risk <7.5% (ΔC-statistic = +0.046; P = 0.02) and 7.5% to 20% (ΔC-statistic = +0.069; P = 0.003), which were larger when compared with persons with a 10-year risk >20% (ΔC-statistic = +0.01; P = 0.54).

conclusionsHigher CAC burden strongly associates with incident SCD beyond traditional risk factors, particularly among primary prevention patients with low-intermediate risk. SCD risk stratification can be useful in the early stages of CHD through the measurement of CAC, identifying patients most likely to benefit from further downstream testing.

Indexed as

Coronary Artery DiseaseVascular CalcificationCalciumDeath, Sudden, CardiacFemaleHumansMaleMiddle AgedPredictive Value of TestsRisk AssessmentRisk FactorsCalciumcardiovascular diseasescoronary artery calciummultidetector computed tomographysudden cardiac death

Identifiers

PMID35370113
PMCPMC9262828
OpenAlexW4221134009

What OpenQuestion holds

Textmetadata
LicenceTDM
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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.