ArticleJournal of the American College of Cardiology2022
Coronary Calcium Scoring Improves Risk Prediction in Patients With Suspected Obstructive Coronary Artery Disease.
Article in Journal of the American College of Cardiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 42 citations in OpenAlex.
- Clinical risk prediction, coronary computed tomography angiography, and cardiovascular events in new-onset chest pain: the PROMISE and SCOT-HEART trials.European heart journal · 2025Trial
- Great debate: the new risk factor-weighted clinical likelihood model is useful to estimate the initial pre-test probability of obstructive coronary artery disease in individuals with suspected chronic coronary syndromes.European heart journal · 2026Article
- Highlights of Cardiovascular Disease Prevention Studies Presented at the 2026 American College of Cardiology Conference.Current atherosclerosis reports · 2026Review
- Comparison of coronary artery calcium score-based and all-coronary computed tomography angiography strategies in patients with stable chest pain and risk factor-weighted clinical likelihood of 5-15.BMC medical imaging · 2026Observational
- Coronary Artery Calcification on Non-Cardiac Gated CT Thorax Scans: A Single Tertiary Centre Retrospective Observational Study.Journal of cardiovascular development and disease · 2025Article
- Clinical likelihood models calibrated against observed obstructive coronary artery disease on computed tomography angiography.European heart journal. Cardiovascular Imaging · 2025Article
- Evaluating the American Heart Association/American College of Cardiology Guideline-Recommended and Contemporary Pretest Probability Models in a Mixed Asian Cohort: The Contribution of Coronary Artery Calcium.Journal of the American Heart Association · 2024Article
- Predicting the presence of coronary plaques featuring high-risk characteristics using polygenic risk scores and targeted proteomics in patients with suspected coronary artery disease.Genome medicine · 2024Article
- Coronary Artery Calcium Score-Weighted Clinical Likelihood Model Performance in Patients with Stable Chest Pain and Coronary Artery Calcium Scores of Zero.Reviews in cardiovascular medicine · 2024Article
- Comparison of the RF-CL and CACS-CL models to estimate the pretest probability of obstructive coronary artery disease and predict prognosis in patients with stable chest pain and diabetes mellitus.Frontiers in cardiovascular medicine · 2024Article
- External validation of novel clinical likelihood models to predict obstructive coronary artery disease and prognosis.Open heart · 2023Article
- Hybridizing machine learning in survival analysis of cardiac PET/CT imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- Coronary Artery Calcium Score Improves Risk Assessment of Symptomatic Patients in Low-Risk Group Based on Current Guidelines.Reviews in cardiovascular medicine · 2023Article
- Using Coronary Artery Calcium Score as Diagnostic Tool in Symptomatic Chronic Coronary Syndrome Patients in a Real-Life Setting.Vascular health and risk management · 2023Article
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10 authors at 5 institutions in 4 countries.
Funding
Abstract
backgroundIn patients with suspected obstructive coronary artery disease (CAD), the risk factor-weighted clinical likelihood (RF-CL) model and the coronary artery calcium score-weighted clinical likelihood (CACS-CL) model improves the identification of obstructive CAD compared with basic pretest probability (PTP) models.
objectivesThe aim of this study was to assess the prognostic value of the new models.
methodsThe incidences of myocardial infarction and death were stratified according to categories by the RF-CL and CACS-CL and compared with categories by the PTP model. We used cohorts from a Danish register (n = 41,177) and a North American randomized study (n = 3,952). All patients were symptomatic and were referred for diagnostic testing because of clinical indications.
resultsDespite substantial down-reclassification of patients to a likelihood ≤5% of CAD with either the RF-CL (45%) or CACS-CL (60%) models compared with the PTP (18%), the annualized event rates of myocardial infarction and death were low using all 3 models; RF-CL 0.51% (95% CI: 0.46-0.56), CACS-CL 0.48% (95% CI: 0.44-0.56), and PTP 0.37% (95% CI: 0.31-0.44), respectively. Overall, comparison of the predictive power of the 3 models using Harrell's C-statistics demonstrated superiority of the RF-CL (0.64 [95% CI: 0.63-0.65]) and CACS-CL (0.69 [95% CI: 0.67-0.70]) compared with the PTP model (0.61 [95% CI: 0.60-0.62]).
conclusionsThe simple clinical likelihood models that include classical risk factors or risk factors combined with CACS provide improved risk stratification for myocardial infarction and death compared with the standard PTP model. Hence, the optimized RF-CL and CACS-CL models identify 2.5 and 3.3 times more patients, respectively, who may not benefit from further diagnostic testing.
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