Evidence map›Paper›PMID 40146086›Full record

ArticleJACC. Heart failure2025

Association of Extracoronary Calcification and Incident Heart Failure in the Multiethnic Study of Atherosclerosis (MESA).

Sandeep Brar, Rahul Goli, Joshua P Barrios, Michael J Blaha, Sina Kianoush, Mark J Pletcher, Sarah O Nomura, Michael Y Tsai, Rong Duan, Matthew J Budoff and 2 more

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

Article in JACC. Heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
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

6 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
  4. Review
  5. Review
  6. Article
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

12 authors.

Sandeep BrarDepartment of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, San Francisco, California, USA.
Rahul GoliDivision of Cardiology, Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
Joshua P BarriosDivision of Cardiology, Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
Michael J BlahaDivision of Cardiology, Department of Medicine, Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Sina KianoushDivision of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
Mark J PletcherDepartment of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, San Francisco, California, USA.
Sarah O NomuraDepartment of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota, USA.
Michael Y TsaiDepartment of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota, USA.
Rong DuanDivision of Cardiology, Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
Matthew J BudoffDivision of Cardiology, Harbor-UCLA Medical Center, The Lundquist Institute, Los Angeles, California, USA.
Moyses SzkloDivision of Cardiovascular and Clinical Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Geoffrey H TisonDivision of Cardiology, Department of Medicine, University of California, San Francisco, San Francisco, California, USA; Bakar Computational Health Sciences Institute, University of California, San Francisco, San Francisco, California, USA; Center for Biosignal Research, University of California, San Francisco, San Francisco, California, USA. Electronic address: geoff.tison@ucsf.edu.

Funding

Ventricular Size and Valve Calcification Measures by CTR01HL071739 · NHLBI · LUNDQUIST INSTITUTE FOR BIOMEDICAL INNOVATION AT HARBOR-UCLA MEDICAL CENTER · PI BUDOFF, MATTHEW J · 2003 to 2010
$2.0M
Dynamic prediction of heart failure using real-time functional status and EHR data in the ambulatory settingK23HL135274 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI TISON, GEOFFREY H · 2018 to 2022
$999k
SUBCLINICAL CARDIOVASCULAR DISEASE STUDYN01HC095166 · HC · UNIVERSITY OF VERMONT &ST AGRIC COLLEGE · PI TRACY, RUSSELL P · 1999 to 2001
$758k
Developing a platform for deep phenotyping of heart failure with preserved ejection fraction using raw, widely-available, multi-modality data and artificial intelligence algorithmsR56HL161475 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI TISON, GEOFFREY H · 2022 to 2022
$721k
SUBCLINICAL CARDIOVASCULAR DISEASE STUDY-FIELD CENTERN01HC095162 · HC · JOHNS HOPKINS UNIVERSITY · PI SZKLO, MOYSES A · 1999 to 2000
$694k
SUBCLINICAL CARDIOVASCULAR DISEASE STUDY--FIELD CENTERN01HC095161 · HC · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI SHEA, STEVEN · 1999 to 2001
$642k
SUBCLINICAL CARDIOVASCULAR DISEASE STUDY--FIELD CENTERN01HC095165 · HC · WAKE FOREST UNIVERSITY · PI BURKE, GREGORY L · 1999 to 2001
$616k
SUBCLINICAL CARDIOVASCULAR DISEASE STUDY--FIELD CENTERN01HC095160 · HC · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI SAAD, MOHAMMED F · 1999 to 2001
$592k
SUBCLINICAL CARDIOVASCULAR DISEASE STUDY-FIELD CENTERN01HC095164 · HC · NORTHWESTERN UNIVERSITY · PI LIU, KIANG JOHN · 1999 to 2001
$511k
SUBCLINICAL CARDIOVASCULAR DISEASE STUDY--FIELD CENTERN01HC095163 · HC · UNIVERSITY OF MINNESOTA TWIN CITIES · PI FOLSOM, AARON R · 1999 to 2001
$443k
SUBCLINICAL CARDIOVASCULAR DISEASE STUDYN01HC095168 · HC · JOHNS HOPKINS UNIVERSITY · PI BLUEMKE, DAVID A. · 1999 to 2000
$375k
SUBCLINICAL CARDIOVASCULAR DISEASE COORDINATING CENTER-N01HC95159-268095159N01HC095159 · HC · UNIVERSITY OF WASHINGTON · PI KRONMAL, RICHARD A · 1999 to 2006
$304k
NHLBI NIH HHS K23 HL135274NHLBI NIH HHS N01 HC095159NHLBI NIH HHS N01 HC095160NHLBI NIH HHS N01 HC095161NHLBI NIH HHS N01 HC095162NHLBI NIH HHS N01 HC095163NHLBI NIH HHS N01 HC095164NHLBI NIH HHS N01 HC095165NHLBI NIH HHS N01 HC095166NHLBI NIH HHS N01 HC095167NHLBI NIH HHS N01 HC095168NHLBI NIH HHS N01 HC095169NHLBI NIH HHS R01 HL071739NHLBI NIH HHS R56 HL161475
6 · The paper itself

Abstract

backgroundExtracoronary calcification (ECC) is a prevalent cardiovascular risk factor.

objectivesThe aim of this study was to examine the association between ECC and heart failure (HF), including heart failure with preserved ejection fraction (HFpEF).

methodsMESA (Multi-Ethnic Study of Atherosclerosis) participants with computed tomographic imaging at baseline for calcification of the aortic valve, aortic root, mitral valve, and thoracic aorta were included. ECC score was calculated by rescaling Agatston scores from 0 to 1 for each ECC site and summing the rescaled scores. Multivariable Cox proportional hazards regression was performed to examine the association between ECC quartiles and incident HF.

resultsOf all MESA participants, 3,617 (53.1%) and 3,192 (46.9%) had ECC scores of 0 and >0, respectively. During a mean follow-up period of 12.9 ± 4.2 years, 358 HF events were observed, 179 HF with reduced ejection fraction and 135 HFpEF. After controlling for demographics and risk factors, the highest ECC quartile (compared with the lowest quartile) had 1.7-fold greater hazard of incident HF (adjusted HR: 1.72 [95% CI: 1.16-2.55]; P = 0.007), though this was attenuated to borderline significance after additional adjustment for coronary artery calcification. In contrast for HFpEF, the highest ECC quartile (compared with the lowest quartile) remained independently and statistically significantly associated with 3-fold greater hazard of incident HFpEF (adjusted HR: 3.09 [95% CI: 1.45-6.60]; P = 0.003) after full adjustment, including for coronary artery calcification.

conclusionsECC is associated with increased risk for HF, in particular HFpEF. If this finding is confirmed in other studies, ECC could help improve traditional risk factor estimation and clinical risk assessments for HF and HFpEF.

Indexed as

AtherosclerosisCalcinosisHeart FailureVascular CalcificationAgedAged, 80 and overAorta, ThoracicAortic ValveEthnicityFemaleHumansIncidenceMaleMiddle AgedMitral ValveProportional Hazards Modelscardiac calcificationcoronary artery calcificationheart failureHFpEF

Identifiers

PMID40146086
PMCPMC12510633

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Registered trials

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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.