Evidence map›Paper›PMID 42189365›Full record

ReviewCurrent atherosclerosis reports2026

Beyond the Coronaries: Utility of Extra-Coronary Calcification for Cardiovascular Risk Assessment in Women.

Emily Littman, Syed Bukhari, Haley Watts, Anum S Minhas, Erin D Michos, Allison G Hays

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In one paragraph

Review in Current atherosclerosis reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

6 authors.

Emily LittmanDepartment of Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Syed BukhariDivision of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Haley WattsDepartment of Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Anum S MinhasDivision of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Erin D MichosDivision of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Allison G HaysDivision of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA. ahays2@jhmi.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purpose of reviewGlobally, cardiovascular disease (CVD) is the leading cause of mortality in women. Traditional risk calculators underestimate atherosclerotic cardiovascular disease risk (ASCVD), particularly in women classified as low or intermediate risk. While coronary artery calcium scoring improves risk stratification, it remains underutilized in practice. Extra-coronary calcification (ECC), including breast arterial calcification, valvular calcification, and thoracic aortic calcification have emerged as promising adjunctive imaging biomarkers for cardiovascular risk assessment in women. RECENT

findingsThe processes of vascular and valvular calcification are influenced by inflammation, osteogenic signaling pathways, and sex hormones. Unique female factors, such as the menopausal transition, parity, and pregnancy-related complications, further influence calcification. The incidental ECC detection that is possible through screening mammography, echocardiography, and chest computed tomography offers an opportunity for cardiovascular risk identification without additional cost or radiation. Evidence has suggested ECC to be independently associated with coronary artery disease, stroke, heart failure, atrial fibrillation, and cardiovascular mortality. Further, studies have shown links between ECC with higher cardiovascular risk, particularly among women whose risk may be underestimated by traditional tools. In women, ECC may be valuable as a complementary ASCVD risk-enhancing marker, serving to augment and expedite preventive care. Heterogeneity in ECC recognition, a lack of standardized scoring, and limited prospective outcome data have prevented the integration of ECC metrics into cardiovascular guidelines to date. Future efforts should prioritize standardized reporting, artificial intelligence-assisted quantification, and well-designed prospective trials to determine whether ECC-guided prevention might improve cardiovascular outcomes in women.

Indexed as

Breast DiseasesCalcinosisCardiovascular DiseasesVascular CalcificationFemaleHeart Disease Risk FactorsHumansRisk AssessmentRisk FactorsAortic valve calcificationBreast arterial calcificationExtra-coronary calcificationMitral annular calcificationThoracic aortic calcification

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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.