Evidence map›Paper›PMID 39821061›Full record

ArticleEuropean journal of preventive cardiology2026

Risk profile and prognostic implications of premature advanced coronary atherosclerotic disease among young to early middle-aged adults: the coronary artery calcium consortium.

Ellen Boakye, Mohammadmoein Dehesh, Zeina Dardari, Olufunmilayo H Obisesan, Albert D Osei, Omar Dzaye, Kunal Jha, Alan Rozanski, Daniel S Berman, Matthew J Budoff and 5 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of preventive cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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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.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors.

Ellen BoakyeJohns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
Mohammadmoein DeheshJohns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
Zeina DardariJohns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
Olufunmilayo H ObisesanDepartment of Medicine, MedStar Union Memorial Hospital, Baltimore, MD  USA.
Albert D OseiDivision of Cardiovascular Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Omar DzayeJohns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.ORCID 0000-0001-9483-3510
Kunal JhaDivision of Cardiovascular Medicine, University of Louisville, Louisville, KY, USA.
Alan RozanskiDivision of Cardiology, Mount Sinai St. Luke's Hospital, New York, NY, USA.
Daniel S BermanDepartments of Imaging and Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Matthew J BudoffHarbor-UCLA Medical Center, The Lundquist Institute, Torrance, CA, USA.ORCID 0000-0002-9616-1946
Michael D MiedemaNolan Family Center for Cardiovascular Health, Minneapolis Heart Institute and Foundation, Minneapolis, MN, USA.
Khurram NasirDivision of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA.
John A RumbergerDepartment of Cardiac Imaging, Princeton Longevity Center, Princeton, NJ, USA.
Leslee J ShawDepartment of Medicine (Cardiology), Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Michael J BlahaJohns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.ORCID 0000-0001-5138-9683

Funding

CAC ConsortiumNHLBI NIH HHS L30 HL110027NIH HHS L30 HL110027
6 · The paper itself

Abstract

aimsPremature advanced subclinical coronary atherosclerosis among young adults is an under-recognized and unique disease phenotype that has not been well characterized. METHODS AND

resultsWe used data from 44 047 participants with no prior CVD history (59.8% male) from the Coronary Artery Calcium (CAC) Consortium. We defined advanced disease as CAC ≥ 90th percentile for age, sex, and race and compared the risk factor profile of persons with advanced disease to those without CAC and those with CAC < 90th percentile. Using multivariable-adjusted Cox proportional hazard and competing risks regression, we assessed the association of premature advanced disease with all-cause, cardiovascular, and coronary heart disease (CHD) mortality. Of 44 047 participants, 18 561 (42.2%) had CAC. Among those with CAC, 6680 (36.0%) had CAC ≥ 90th percentile. Notably, 76.4% of those with CAC ≥ 90th percentile had multivessel CAC compared with 40.6% of those with CAC < 90th percentile. After a mean follow-up of 12.5 ± 3.6 years, the incidence per 1000 person-years of all-cause (2.93 vs. 1.85 vs. 1.11), cardiovascular (1.11 vs. 0.39 vs. 0.21), and CHD mortality (0.65 vs. 0.19 vs. 0.08) was highest in the advanced disease group compared with CAC < 90th percentile and the no CAC group. Persons with CAC ≥ 90th percentile had a higher multivariable-adjusted risk of all-cause [HR: 2.17 (1.83-2.57)], cardiovascular [sub-distribution hazard ratios (SHR): 3.89 (2.78-5.44)], and CHD mortality [SHR: 5.45 (3.38-8.78)], compared with those without CAC. In the subgroup analysis, there was no difference in mortality between men and women with advanced CAC.

conclusionPremature advanced atherosclerosis is a distinct clinical phenotype that strongly predicts all-cause and cause-specific mortality. Among persons with CAC at young age, those with scores ≥90th percentile have the highest risk of early death and should be identified in future guidelines as a focus for aggressive clinical prevention.

Indexed as

Coronary Artery DiseaseVascular CalcificationAdultAge FactorsAge of OnsetAsymptomatic DiseasesCause of DeathCoronary AngiographyDisease ProgressionFemaleHeart Disease Risk FactorsHumansIncidenceMaleMiddle AgedPhenotypeAdvanced diseaseAtherosclerotic cardiovascular diseaseCoronary artery calciumMortality

Identifiers

PMID39821061
PMCPMC13364049

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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.