The DOI matches its Crossref record; 33 of the 33 references it cites were found in a registry or an index.
Prognostic Value of Coronary CT Angiography and Calcium Score for Major Adverse Cardiac Events in Outpatients
Open accessAbstract
Objectives This study sought to evaluate the prognostic value of coronary artery calcium score (CACS) and coronary computed tomography angiography (CTA) for major adverse cardiac events (MACE). Background The prognostic value of CACS has been well described. Few studies use the rich information of coronary CTA to predict future clinical outcomes and compare CACS with coronary CTA. Methods We followed up 5,007 outpatients who were suspected of having coronary artery disease (CAD) and who underwent cardiac CTA. Cardiac CT was assessed for CACS and the extent, the location, the stenosis severity, and the composition of the plaque in coronary CTA. The endpoint was MACE, defined as composite cardiac death, nonfatal myocardial infarction, or coronary revascularization. Results Follow-up was completed in 4,425 patients (88.4%), with a median follow-up period of 1,081 days. At the end of the follow-up period, 363 (8.2%) patients had experienced MACE. Cumulative probability of 3-year MACE increased across CT strata for CACS (CACS 0, 2.1%; CACS 1 to 100, 12.9%; CACS 101 to 400, 16.3%; and CACS >400, 33.8%; log-rank p < 0.001); for coronary CTA (no plaque 0.8%, nonobstructive disease 3.7%, 1-vessel disease 27.6%, 2-vessel disease 35.5%, and 3-vessel disease 57.7%; log-rank p < 0.001); and for characteristics of the plaques (5.5% for calcified plaque, 22.7% for noncalcified plaque, and 37.7% for mixed plaque; log-rank p < 0.001). The area under the receiver-operating characteristic curves showed the incremental value of CACS and coronary CTA for predicting MACE: 0.71 for clinical risk factors, which improved to 0.82 by adding CACS and further improved to 0.93 by adding coronary CTA (both p < 0.001). Conclusions The CACS and coronary CTA findings have prognostic value and have incremental value over routine risk factors for MACE, and coronary CTA is superior to CACS. Cardiac CT seems to be a promising noninvasive modality with significant prognostic value.
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“Since calcified plaques are more stable and less prone to rupture than mixed and non-calcified plaques”
From Lifelong endurance exercise and its relation with coronary atherosclerosis (2023) · cites this paper as [20]
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“This is clinically relevant because these plaque types are more vulnerable to plaque rupture than calcified plaques.10,11”
From Wearable-Derived Training Load and Coronary Atherosclerosis in Middle-Aged and Older Athletes and Physically Active Controls: A New Perspective From the Master@Heart Study (2026) · cites this paper as [10]
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“the type of plaque is important for the risk of cardiac events 3 , with a lower risk attributed to calcified plaques compared to non-calcified and mixed plaques”
From Relationship between lifelong exercise volume and coronary atherosclerosis in athletes. (2017) · cites this paper as [3]
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“A previous study estimated the 3-year probability of major adverse cardiac events at 6% for calcified plaques, 23% for non-calcified plaques and 38% for mixed plaques in a cohort of patients suspected of having coronary artery disease 3 .”
From Relationship between lifelong exercise volume and coronary atherosclerosis in athletes. (2017) · cites this paper as [3]
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“However, the difference between CAC=0 and CAC>0 is significant, with estimated 3-year probabilities of major adverse cardiac events of 2.1% for CAC score=0; 13% for a CAC score between 1 to 100; 16% for CAC score between 101 and 400; and 34% for a CAC score above 400 3 .”
From Relationship between lifelong exercise volume and coronary atherosclerosis in athletes. (2017) · cites this paper as [3]
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Quantification of coronary artery calcium using ultrafast computed tomography
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Self-citationElectron-Beam Tomography Coronary Artery Calcium and Cardiac Events
Kondos, G. T., Hoff, J. A., Sevrukov, A., Daviglus, M. L., Garside, D. B., Devries, S. S., Chomka, E. V., & Liu, K. (2003) · Circulation · doi:10.1161/01.cir.0000068341.61180.55 · Cited by 732
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Borén, J., Chapman, M. J., Krauss, R. M., Packard, C. J., Bentzon, J. F., Binder, C. J., Daemen, M. J., Demer, L. L., Hegele, R. A., Nicholls, S. J., et al. (2020) · European Heart Journal · doi:10.1093/eurheartj/ehz962 · Cited by 1,601
Calcium Density of Coronary Artery Plaque and Risk of Incident Cardiovascular Events
Criqui, M. H., Denenberg, J. O., Ix, J. H., McClelland, R. L., Wassel, C. L., Rifkin, D. E., Carr, J. J., Budoff, M. J., & Allison, M. A. (2014) · JAMA · doi:10.1001/jama.2013.282535 · Cited by 642
Self-citationFranklin, B. A., Thompson, P. D., Al-Zaiti, S. S., Albert, C. M., Hivert, M.-F., Levine, B. D., Lobelo, F., Madan, K., Sharrief, A. Z., Eijsvogels, T. M. H., et al. (2020) · Circulation · doi:10.1161/cir.0000000000000749 · Cited by 410
Relationship between lifelong exercise volume and coronary atherosclerosis in athletes.
Aengevaeren, V. L., Mosterd, A., Braber, T. L., Prakken, N. H. J., Doevendans, P. A., Grobbee, D. E., Thompson, P. D., Eijsvogels, T. M. H., & Velthuis, B. K. (2017) · Circulation · doi:10.1161/circulationaha.117.027834 · Cited by 312
Budoff, M. J., Mayrhofer, T., Ferencik, M., Bittner, D. O., Lee, K. L., Lu, M. T., Coles, A., Jang, J. J., Krishnam, M. S., Douglas, P. S., et al. (2017) · Circulation · doi:10.1161/circulationaha.117.030578 · Cited by 293
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Metadata
- Authors
- Hou, Z.-H., Lu, B., Gao, Y., Jiang, S.-L., Wang, Y., Li, W., & Budoff, M. J.
- Affiliations
- Chinese Academy of Medical Sciences & Peking Union Medical College (CN)
- Harbor–UCLA Medical Center (US)
- Venue
- JACC: Cardiovascular Imaging
- Publisher
- Elsevier BV
- Published
- 2012-10
- Volume
- 5
- Issue
- 10
- Pages
- 990-999
- ISSN
- 1876-7591 (ISSN-L)
- 1936-878X
- OpenAlex
- W2093627517
- Cited by
- 321
- References
- 33
- Citations by year
- 2026: 12 · 2025: 17 · 2024: 26 · 2023: 31 · 2022: 22 · 2021: 33 · 2020: 38 · 2019: 19 · 2018: 18 · 2017: 20 · 2016: 27 · 2015: 23 · 2014: 17 · 2013: 15 · 2012: 2
- FWCI
- 13.78
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- JACC. Cardiovascular imaging (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ministry of Science and Technology of China (2007BAI05B02)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Coronary Interventions and Diagnostics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Coronary Artery Anomalies
- Keywords
- coronary artery calcium score, coronary CT angiography, major adverse cardiac events, coronary artery disease, prognostic value, plaque composition, non-calcified plaque, mixed plaque, calcified plaque, coronary stenosis severity, risk stratification, outpatients, incremental prognostic value, myocardial infarction, coronary revascularization, cardiovascular mortality, risk prediction model, incremental area under the curve
- MeSH terms
- Aged, Ambulatory Care, Coronary Artery Disease, Female, Humans, Male, Middle Aged, Myocardial Infarction, Myocardial Revascularization, Outpatients, Predictive Value of Tests, Prognosis, Retrospective Studies, Risk Factors, ROC Curve, Severity of Illness Index, Time Factors, Chi-Square Distribution, Proportional Hazards Models, Coronary Angiography, Disease Progression, Risk Assessment, Area Under Curve, Kaplan-Meier Estimate, Vascular Calcification, Multidetector Computed Tomography
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