Evidence map›Paper›PMID 38385932›Full record

ArticleJACC. Cardiovascular imaging2024

Left Main Coronary Artery Calcium and Diabetes Confer Very-High-Risk Equivalence in Coronary Artery Calcium >1,000.

Alexander C Razavi, Leslee J Shaw, Daniel S Berman, Matthew J Budoff, Nathan D Wong, Viola Vaccarino, Marly van Assen, Carlo N De Cecco, Arshed A Quyyumi, Anurag Mehta and 11 more

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

Article in JACC. Cardiovascular imaging, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
6.1field-weighted citation impact, top 3% 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

7 citing papers in PubMed, 15 citations in OpenAlex.

  1. Review
  2. Article
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  6. Advances in targeting LDL cholesterol: PCSK9 inhibitors and beyond.American journal of preventive cardiology · 2024
    Article
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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

21 authors at 13 institutions in 2 countries.

Alexander C RazaviEmory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA; Translational Laboratory for Cardiothoracic Imaging and Artificial Intelligence, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA.
Leslee J ShawIcahn School of Medicine at Mount Sinai, Blavatnik Family Women's Health Research Institute, New York, New York, 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.
Nathan D WongHeart Disease Prevention Program, Division of Cardiology, Department of Medicine, University of California, Irvine, California, USA.
Viola VaccarinoEmory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA.
Marly van AssenTranslational Laboratory for Cardiothoracic Imaging and Artificial Intelligence, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA.
Carlo N De CeccoTranslational Laboratory for Cardiothoracic Imaging and Artificial Intelligence, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA.
Arshed A QuyyumiEmory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA.
Anurag MehtaVCU Health Pauley Heart Center and Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA.
Paul MuntnerDepartment of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Michael D MiedemaNolan Family Center for Cardiovascular Health, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA.
Alan RozanskiDivision of Cardiology, Mount Sinai, St Luke's Hospital, New York, New York, USA.
John A RumbergerCorazon Imaging, Columbus, Ohio, USA.
Khurram NasirDivision of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA.
Roger S BlumenthalJohns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Laurence S SperlingEmory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA.
Martin Bødtker MortensenDepartment of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
Seamus P WheltonJohns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Michael J BlahaJohns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Omar DzayeJohns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. Electronic address: odzaye@jhmi.edu.
Emory University · USJohns Hopkins University · USAarhus University Hospital · DKCedars-Sinai Medical Center · USEmory Healthcare · USHouston Methodist · USIcahn School of Medicine at Mount Sinai · USMinneapolis Heart Institute Foundation · USSt. Luke's Hospital · USUCLA Medical Center · USUniversity of Alabama at Birmingham · USUniversity of California, Irvine · USVirginia Commonwealth University · 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

backgroundAlthough a coronary artery calcium (CAC) of ≥1,000 is a subclinical atherosclerosis threshold to consider combination lipid-lowering therapy, differentiating very high from high atherosclerotic cardiovascular disease (ASCVD) risk in this patient population is not well-defined.

objectivesAmong persons with a CAC of ≥1,000, the authors sought to identify risk factors equating with very high-risk ASCVD mortality rates.

methodsThe authors studied 2,246 asymptomatic patients with a CAC of ≥1,000 from the CAC Consortium without a prior ASCVD event. Cox proportional hazards regression modelling was performed for ASCVD mortality during a median follow-up of 11.3 years. Crude ASCVD mortality rates were compared with those reported for secondary prevention trial patients classified as very high risk, defined by ≥2 major ASCVD events or 1 major event and ≥2 high-risk conditions (1.4 per 100 person-years).

resultsThe mean age was 66.6 years, 14% were female, and 10% were non-White. The median CAC score was 1,592 and 6% had severe left main (LM) CAC (vessel-specific CAC ≥300). Diabetes (HR: 2.04 [95% CI: 1.47-2.83]) and severe LM CAC (HR: 2.32 [95% CI: 1.51-3.55]) were associated with ASCVD mortality. The ASCVD mortality per 100 person-years for all patients was 0.8 (95% CI: 0.7-0.9), although higher rates were observed for diabetes (1.4 [95% CI: 0.8-1.9]), severe LM CAC (1.3 [95% CI: 0.6-2.0]), and both diabetes and severe LM CAC (7.1 [95% CI: 3.4-10.8]).

conclusionsAmong asymptomatic patients with a CAC of ≥1,000 without a prior index event, diabetes, and severe LM CAC define very high risk ASCVD, identifying individuals who may benefit from more intensive prevention therapies across several domains, including low-density lipoprotein-cholesterol lowering.

Indexed as

Coronary AngiographyCoronary Artery DiseaseDiabetes MellitusPredictive Value of TestsVascular CalcificationAgedAsymptomatic DiseasesComputed Tomography AngiographyCoronary VesselsFemaleHeart Disease Risk FactorsHumansMaleMiddle AgedPrognosisRisk Assessmentatherosclerotic cardiovascular diseasecoronary artery calciumdiabetesLDL cholesterolvery high risk

Identifiers

PMID38385932
PMCPMC12276879
OpenAlexW4391993633

What OpenQuestion holds

Textmetadata
LicenceTDM
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.