Statin Trials, Cardiovascular Events, and Coronary Artery Calcification
Open accessAbstract
Objectives This study sought to determine whether coronary artery calcium (CAC) could be used to optimize statin allocation among individuals for whom trial-based evidence supports efficacy of statin therapy.Background Recently, allocation of statins was proposed for primary prevention of atherosclerotic cardiovascular disease (ASCVD) based on proven efficacy from randomized controlled trials (RCTs) of statin therapy, a so-called trial-based approach.Methods The study used data from MESA (Multi-Ethnic Study of Atherosclerosis) with 5,600 men and women, 45 to 84 years of age, and free of clinical ASCVD, lipid-lowering therapy, or missing information for risk factors at baseline examination.Results During 10 years' follow-up, 354 ASCVD and 219 hard coronary heart disease (CHD) events occurred. Based on enrollment criteria for 7 RCTs of statin therapy in primary prevention, 73% of MESA participants (91% of those >55 years of age) were eligible for statin therapy according to a trial-based approach. Among those individuals, CAC = 0 was common (44%) and was associated with low rates of ASCVD and CHD (3.9 and 1.7, respectively, per 1,000 person-years). There was a graded increase in event rates with increasing CAC score, and in individuals with CAC >100 (27% of participants) the rates of ASCVD and CHD were 18.9 and 12.7, respectively. Consequently, the estimated number needed to treat (NNT) in 10 years to prevent 1 event varied greatly according to CAC score. For ASCVD events, the NNT was 87 for CAC = 0 and 19 for CAC >100. For CHD events, the NNT was 197 for CAC = 0 and 28 for CAC >100.Conclusions Most MESA participants qualified for trial-based primary prevention with statins. Among the individuals for whom trial-based evidence supports efficacy of statin therapy, CAC = 0 and CAC >100 were common and associated with low and high cardiovascular risks, respectively. This information may guide shared decision making aimed at targeting evidence-based statins to those who are likely to benefit the most.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Detection of coronary artery calcification with noncontrast computed tomography gives a good estimate of atherosclerotic burden and is strongly associated with cardiovascular events.
“Detection of coronary artery calcification with noncontrast computed tomography (CT) gives a good estimate of the atherosclerotic burden and is strongly associated with CV events [18].”
From 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk (2019) · cites this paper as [18]
Anti-inflammatory and antioxidant effects of statins have been shown in vitro and in experimental systems, but their clinical relevance remains unproven.
“These effects have been shown in vitro and in experimental systems, but their clinical relevance remains unproven [18,206].”
From 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk (2019) · cites this paper as [18]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
European Guidelines on cardiovascular disease prevention in clinical practice (version 2012)
Authors/Task Force Members:, Perk, J., De Backer, G., Gohlke, H., Graham, I., Reiner, Ž., Verschuren, M., Albus, C., Benlian, P., Boysen, G., et al. (2012) · European Heart Journal · doi:10.1093/eurheartj/ehs092 · Cited by 8,490 · see citing works
Prevention of Coronary Heart Disease with Pravastatin in Men with Hypercholesterolemia
Shepherd, J., Cobbe, S. M., Ford, I., Isles, C. G., Lorimer, A. R., Macfarlane, P. W., McKillop, J. H., & Packard, C. J. (1995) · New England Journal of Medicine · doi:10.1056/nejm199511163332001 · Cited by 7,449 · see citing works
Stone, N. J., Robinson, J. G., Lichtenstein, A. H., Bairey Merz, C. N., Blum, C. B., Eckel, R. H., Goldberg, A. C., Gordon, D., Levy, D., Lloyd-Jones, D. M., et al. (2014) · Circulation · doi:10.1161/01.cir.0000437738.63853.7a · Cited by 7,081 · see citing works
Rosuvastatin to Prevent Vascular Events in Men and Women with Elevated C-Reactive Protein
Ridker, P. M., Danielson, E., Fonseca, F. A. H., Genest, J., Gotto, A. M., Kastelein, J. J. P., Koenig, W., Libby, P., Lorenzatti, A. J., MacFadyen, J. G., et al. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa0807646 · Cited by 6,674 · cited 2× · see citing works
“A trial-based approach to statin therapy for primary prevention based on currently available evidence is guided by enrollment criteria in the following 7 large RCTs (named in chronological order by publication year): WOSCOPS (West of Scotland Coronary Prevention Study) (10), AFCAPS/ TexCAPS (Air Force/Texas Coronary A…”
BackgroundMethod2016 European Guidelines on cardiovascular disease prevention in clinical practice
Piepoli, M. F., Hoes, A. W., Agewall, S., Albus, C., Brotons, C., Catapano, A. L., Cooney, M.-T., Corrà, U., Cosyns, B., Deaton, C., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw106 · Cited by 6,457 · see citing works
Downs, J. R., Clearfield, M., Weis, S., Whitney, E., Shapiro, D. R., Beere, P. A., Langendorfer, A., Stein, E. A., Kruyer, W., Gotto, Jr., et al. (1998) · JAMA · doi:10.1001/jama.279.20.1615 · Cited by 5,236 · cited 2× · see citing works
“A trial-based approach to statin therapy for primary prevention based on currently available evidence is guided by enrollment criteria in the following 7 large RCTs (named in chronological order by publication year): WOSCOPS (West of Scotland Coronary Prevention Study) (10), AFCAPS/ TexCAPS (Air Force/Texas Coronary A…”
MethodMulti-Ethnic Study of Atherosclerosis: Objectives and Design
Bild, D. E. (2002) · American Journal of Epidemiology · doi:10.1093/aje/kwf113 · Cited by 3,942 · cited 1× · see citing works
“Details on the design and organization were published previously (9).”
BackgroundStone, N. J., Robinson, J. G., Lichtenstein, A. H., Bairey Merz, C. N., Blum, C. B., Eckel, R. H., Goldberg, A. C., Gordon, D., Levy, D., Lloyd-Jones, D. M., et al. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2013.11.002 · Cited by 3,845 · see citing works
Sever, P., Dahlöf, B., Poulter, N. R., Wedel, H., Beevers, G., Caulfield, M. J., Collins, R., Kjeldsen, S. E., Kristinsson, A., McInnes, G. T., et al. (2003) · The Lancet · doi:10.1016/s0140-6736(03)12948-0 · Cited by 3,756 · see citing works
Colhoun, H. M., Betteridge, D. J., Durrington, P. N., Hitman, G. A., W Neil, H. A., Livingstone, S. J., Thomason, M. J., Mackness, M. I., Charlton-Menys, V., & Fuller, J. H. (2004) · The Lancet · doi:10.1016/s0140-6736(04)16895-5 · Cited by 3,755 · cited 3× · see citing works
“A trial-based approach to statin therapy for primary prevention based on currently available evidence is guided by enrollment criteria in the following 7 large RCTs (named in chronological order by publication year): WOSCOPS (West of Scotland Coronary Prevention Study) (10), AFCAPS/ TexCAPS (Air Force/Texas Coronary A…”
MethodRosuvastatin to Prevent Vascular Events in Men and Women With Elevated C-Reactive Protein
Ridker, P. M., Danielson, E., Fonseca, F. A. H., Genest, J. J., Gotto, A. M., Kastelein, J. J. P., Köenig, W., Libby, P., Lorenzatti, A. J., MacFadyen, J. G., et al. (2009) · Obstetrical & Gynecological Survey · doi:10.1097/01.ogx.0000344393.60303.0a · Cited by 3,641 · see citing works
PREVENTION OF CORONARY HEART DISEASE WITH PRAVASTATIN IN MEN WITH HYPERCHOLESTEROLEMIA
Hepherd, J. A. S., Obbe, S. T. M. C., Ord, I. A. F., Sles, C. H. G. I., Orimer, A. R. O. L., Acfarlane, P. E. W. M., Illop, J. A. H. M. C. K., Ackard, C. H. J. P., & Roup, S. T. G. (1995) · Cited by 3,453 · see citing works
Statins for the primary prevention of cardiovascular disease
Taylor, F., Huffman, M. D., Macedo, A. F., Moore, T. H., Burke, M., Davey Smith, G., Ward, K., Ebrahim, S., & Gay, H. C. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004816.pub5 · Cited by 1,934 · see citing works
Prescribing Personalized Nutrition for Cardiovascular Health: Are We Ready?
Juma, S., Imrhan, V., Vijayagopal, P., & Prasad, C. (2014) · Lifestyle Genomics · doi:10.1159/000370213 · Cited by 1,905 · see citing works
A strategy to reduce cardiovascular disease by more than 80%
Wald, N., & Law, M. R. (2003) · BMJ · doi:10.1136/bmj.326.7404.1419 · Cited by 1,568 · cited 1× · see citing works
“Hence, after publication of the statin arm of HOPE-3, near-complete RCT evidence has now been provided for a universal, pragmatic approach to primary prevention of ASCVD based on a fixed low-to-moderate statin dose from age 55 – a provocative concept introduced by Wald and Law in 2003(27).”
BackgroundNakamura, H., Arakawa, K., Itakura, H., Kitabatake, A., Goto, Y., Toyota, T., Nakaya, N., Nishimoto, S., Muranaka, M., Yamamoto, A., et al. (2006) · The Lancet · doi:10.1016/s0140-6736(06)69472-5 · Cited by 941 · cited 2× · see citing works
“A trial-based approach to statin therapy for primary prevention based on currently available evidence is guided by enrollment criteria in the following 7 large RCTs (named in chronological order by publication year): WOSCOPS (West of Scotland Coronary Prevention Study) (10), AFCAPS/ TexCAPS (Air Force/Texas Coronary A…”
MethodCholesterol Lowering in Intermediate-Risk Persons without Cardiovascular Disease
Yusuf, S., Bosch, J., Dagenais, G., Zhu, J., Xavier, D., Liu, L., Pais, P., López-Jaramillo, P., Leiter, L. A., Dans, A., et al. (2016) · New England Journal of Medicine · doi:10.1056/nejmoa1600176 · Cited by 848 · cited 3× · see citing works
“A trial-based approach to statin therapy for primary prevention based on currently available evidence is guided by enrollment criteria in the following 7 large RCTs (named in chronological order by publication year): WOSCOPS (West of Scotland Coronary Prevention Study) (10), AFCAPS/ TexCAPS (Air Force/Texas Coronary A…”
BackgroundMethodJBS3 Board (2014) · Heart · doi:10.1136/heartjnl-2014-305693 · Cited by 608 · see citing works
Nasir, K., Bittencourt, M. S., Blaha, M. J., Blankstein, R., Agatson, A. S., Rivera, J. J., Miedema, M. D., Sibley, C. T., Shaw, L. J., Blumenthal, R. S., et al. (2015) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2015.07.066 · Cited by 488 · see citing works
Self-citationStatins: new American guidelines for prevention of cardiovascular disease
Ridker, P. M., & Cook, N. R. (2013) · The Lancet · doi:10.1016/s0140-6736(13)62388-0 · Cited by 477 · see citing works
Absence of Coronary Artery Calcification and All-Cause Mortality
Blaha, M. J., Budoff, M. J., Shaw, L. J., Khosa, F., Rumberger, J. A., Berman, D. S., Callister, T. Q., Raggi, P., Blumenthal, R. S., & Nasir, K. (2009) · JACC. Cardiovascular imaging · doi:10.1016/j.jcmg.2009.03.009 · Cited by 458 · see citing works
Self-citationBlaha, M. J., Budoff, M. J., DeFilippis, A. P., Blankstein, R., Rivera, J. J., Agatston, A. S., O’Leary, D. H., Lima, J. A. C., Blumenthal, R. S., & Nasir, K. (2011) · The Lancet · doi:10.1016/s0140-6736(11)60784-8 · Cited by 342 · see citing works
Self-citationStatins for the primary prevention of cardiovascular disease
Ebrahim, S. B. J., Taylor, F. C., & Brindle, P. (2014) · BMJ · doi:10.1136/bmj.g280 · Cited by 331 · see citing works
Assessing the Impact of Medication Adherence on Long-Term Cardiovascular Outcomes
Bansilal, S., Castellano, J. M., Garrido, E. D. R., Wei, H. G., Freeman, A. N., Spettell, C. M., García-Alonso, F., Lizano‐Díez, I., Arnold, R. J. G., Rajda, J., et al. (2016) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2016.06.005 · Cited by 312 · cited 1× · see citing works
“In patients with detectable CAC, knowing this may increase adherence to preventive medication (37), which may further improve ASCVD outcome (38).”
BackgroundA 15-Year Warranty Period for Asymptomatic Individuals Without Coronary Artery Calcium
Valenti, V., Hartaigh, B. Ó., Heo, R., Cho, I., Schulman‐Marcus, J., Gransar, H., Truong, Q. A., Shaw, L. J., Knapper, J. T., Kelkar, A. A., et al. (2015) · JACC. Cardiovascular imaging · doi:10.1016/j.jcmg.2015.01.025 · Cited by 267 · see citing works
Budoff, M. J., McClelland, R. L., Nasir, K., Greenland, P., Kronmal, R. A., Kondos, G. T., Shea, S., Lima, J. A. C., & Blumenthal, R. S. (2009) · American Heart Journal · doi:10.1016/j.ahj.2009.08.007 · Cited by 264 · see citing works
Self-citationDyslipidemia, Coronary Artery Calcium, and Incident Atherosclerotic Cardiovascular Disease
Martin, S. S., Blaha, M. J., Blankstein, R., Agatston, A. A., Rivera, J. J., Virani, S. S., Ouyang, P., Jones, S. R., Blumenthal, R. S., Budoff, M. J., et al. (2013) · Circulation · doi:10.1161/circulationaha.113.003625 · Cited by 250 · cited 2× · see citing works
“Of course, to prevent events, there need to be events to prevent (19).”
BackgroundSelf-citationLong-Term Use of Cardiovascular Drugs
Rosselló, X., Pocock, S., & Julian, D. G. (2015) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2015.07.018 · Cited by 167 · cited 1× · see citing works
“Thus, in primary prevention, it makes sense to identify those with CAC 1⁄4 0 to avoid overtreatment and those with CAC >100 to avoid undertreatment and ensure long-term adherence to a cost-effective treatment (34).”
BackgroundRidker, P. M., MacFadyen, J. G., Fonseca, F. A. H., Genest, J. J., Gotto, A. M., Kastelein, J. J. P., Köenig, W., Libby, P., Lorenzatti, A. J., Nordestgaard, B. G., et al. (2009) · Circulation Cardiovascular Quality and Outcomes · doi:10.1161/circoutcomes.109.848473 · Cited by 165 · see citing works
Clinician-Patient Risk Discussion for Atherosclerotic Cardiovascular Disease Prevention
Martin, S. S., Sperling, L. S., Blaha, M. J., Wilson, P. W. F., Gluckman, T. J., Blumenthal, R. S., & Stone, N. J. (2015) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2015.01.043 · Cited by 156 · cited 1× · see citing works
“These considerations are obvious topics for evidence-based and meaningful patient-physician discussions on initiation of statin therapy for primary prevention (39).”
BackgroundSelf-citationStatin Therapy for Primary Prevention of Cardiovascular Disease
Taylor, F. C., Huffman, M. D., & Ebrahim, S. B. J. (2013) · JAMA · doi:10.1001/jama.2013.281348 · Cited by 141 · cited 2× · see citing works
“Third, we assumed a 30% relative risk reduction with statin therapy based on Cochrane analyses (22), although that may have varied according to both treatment time and dose/type of statin.”
BackgroundMethodMamudu, H. M., Paul, T. K., Veeranki, S. P., & Budoff, M. J. (2014) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2014.07.022 · Cited by 135 · cited 1× · see citing works
“In patients with detectable CAC, knowing this may increase adherence to preventive medication (37), which may further improve ASCVD outcome(38).”
BackgroundSelf-citationMortensen, M. B., Fuster, V., Muntendam, P., Mehran, R., Baber, U., Sartori, S., & Falk, E. (2016) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2016.05.084 · Cited by 135 · see citing works
Self-citationBlaha, M. J., Silverman, M. G., & Budoff, M. J. (2014) · Circulation Cardiovascular Imaging · doi:10.1161/circimaging.113.000341 · Cited by 115 · cited 1× · see citing works
“In the present study, we confirmed that CAC 1⁄4 0 at baseline examination was associated with very low CHD and ASCVD event rates for at least 10 years, known as the power of zero (35).”
BackgroundSelf-citationUsing the Coronary Artery Calcium Score to Guide Statin Therapy
Pletcher, M. J., Pignone, M. P., Earnshaw, S., McDade, C. L., Phillips, K. A., Auer, R., Zablotska, L. B., & Greenland, P. (2014) · Circulation Cardiovascular Quality and Outcomes · doi:10.1161/circoutcomes.113.000799 · Cited by 113 · cited 1× · see citing works
“z$100), the additional information on ASCVD risk that CAC provides (especially when treatment decision is uncertain) may be worth the expense and, under some circumstances, even be cost-effective (36).”
BackgroundBittencourt, M. S., Blaha, M. J., Blankstein, R., Budoff, M., Vargas, J. D., Blumenthal, R. S., Agatston, A. S., & Nasir, K. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2013.08.1640 · Cited by 70 · see citing works
Self-citationPrimary Prevention With Statins
Mortensen, M. B., Afzal, S., Nordestgaard, B. G., & Falk, E. (2015) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2015.09.089 · Cited by 65 · cited 2× · see citing works
“Unfortunately, as recently highlighted (8), most individuals eligible for statin therapy using a trial-based approach are at low absolute risk of ASCVD, in whom the net benefit of treatment may be questioned.”
BackgroundResultSelf-citationDo Current Clinical Trials Meet Society’s Needs?
Pocock, S., & Gersh, B. J. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2014.08.008 · Cited by 51 · cited 1× · see citing works
“However, potential exclusion criteria were not mentioned in the trial-based proposal and are often ignored in routine clinical practices (40).”
BackgroundA Trial-Based Approach to Statin Guidelines
Ridker, P. M., & Wilson, P. W. F. (2013) · JAMA · doi:10.1001/jama.2013.276529 · Cited by 51 · see citing works
Healthy Volunteer Effect and Cardiovascular Risk
Leening, M. J. G., Heeringa, J., Deckers, J. W., Franco, O. H., Hofman, A., Witteman, J. C. M., & Stricker, B. H. C. (2014) · Epidemiology · doi:10.1097/ede.0000000000000091 · Cited by 41 · cited 1× · see citing works
“This proportion would most likely be even higher in a real-world population(26).”
BackgroundPiepoli, M. F., Hoes, A. W., Brotons, C., Hobbs, R. F., Corrà, U., & on behalf of the Task Force for the 2016 guidelines on cardiovascular disease prevention in clinical practice (2017) · European Journal of General Practice · doi:10.1080/13814788.2017.1398320 · Cited by 41 · see citing works
A Zero Coronary Artery Calcium Score
Hecht, H. S. (2010) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2009.09.064 · Cited by 30 · see citing works
Pavlović, J., Greenland, P., Deckers, J. W., Brugts, J. J., Kavousi, M., Dhana, K., Ikram, M. A., Albert Hofman, D., Stricker, B. H. C., Franco, O. H., et al. (2016) · JAMA Cardiology · doi:10.1001/jamacardio.2016.1577 · Cited by 26 · cited 1× · see citing works
“Similar results were recently reported from 2 European population-based cohort studies, the Copenhagen General Population Study (56%) (8) and the Rotterdam Study (53%) (25).”
ResultRidker, P. M., Rose, L. M., & Cook, N. R. (2015) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2014.12.028 · Cited by 24 · see citing works
Ridker, P. M. (2012) · Circulation Cardiovascular Quality and Outcomes · doi:10.1161/circoutcomes.112.966556 · Cited by 15 · see citing works
When Nothing Is Really Something
Greenland, P. (2015) · JACC. Cardiovascular imaging · doi:10.1016/j.jcmg.2015.02.028 · Cited by 10 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Mach, F., Baigent, C., Catapano, A. L., Koskinas, K. C., Casula, M., Badimon, L., Chapman, M. J., De Backer, G. G., Delgado, V., Ference, B. A., et al. (2019) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2019.08.014 · Cited by 4,854 · see citing works
“7 per 1000 personyears, respectively.(18) Compared with a strategy of treating all patients, the use of CAC score to guide long-term statin therapy has been shown to be cost-effective.”
Anderson, T. J., Grégoire, J., Pearson, G. J., Barry, A. R., Couture, P., Dawes, M., Francis, G. A., Genest, J., Grover, S., Gupta, M., et al. (2016) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2016.07.510 · Cited by 1,173 · see citing works
Coronary Calcium Score and Cardiovascular Risk
Greenland, P., Blaha, M. J., Budoff, M. J., Erbel, R., & Watson, K. E. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.05.027 · Cited by 967 · see citing works
Self-citationPearson, G. J., Thanassoulis, G., Anderson, T. J., Barry, A. R., Couture, P., Dayan, N., Francis, G. A., Genest, J. J., Grégoire, J. C., Grover, S. A., et al. (2021) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2021.03.016 · Cited by 870 · see citing works
Duan, Y., Gong, K., Xu, S., Zhang, F., Meng, X., & Han, J. (2022) · Signal Transduction and Targeted Therapy · doi:10.1038/s41392-022-01125-5 · Cited by 538 · see citing works
“However, the clinical significance of these positive effects on ASCVD may need more exploration.(222,223) Although the efficacy of statins in lowering LDL-C and treating ASCVD is unquestionable, there are still many controversies regarding the application of statins.”
BackgroundImpact of Statins on Cardiovascular Outcomes Following Coronary Artery Calcium Scoring
Mitchell, J. D., Fergestrom, N. M., Gage, B. F., Paisley, R., Moon, P. S., Novak, E. L., Cheezum, M. K., Shaw, L. J., & Villines, T. C. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.09.051 · Cited by 321 · see citing works
Disorders of lipid metabolism. Clinical Guidelines 2023
Владиславович, Е. М., Kukharchuk, V. V., Сергиенко, И. В., Alieva, A. S., Antsiferov, M. B., Ansheles, A. A., Arabidze, G. G., Dm, A., Arutyunov, G. P., Ахмеджанов, Н. М., et al. (2023) · Russian Journal of Cardiology · doi:10.15829/1560-4071-2023-5471 · Cited by 260 · see citing works
Primary Prevention With Statins in the Elderly
Mortensen, M. B., & Falk, E. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.10.080 · Cited by 161 · see citing works
“Today, nearly all apparently healthy elderly individuals have RCT evidence supporting statin efficacy (31).”
BackgroundSelf-citationMiname, M. H., Bittencourt, M. S., de Moraes, S. R., Alves, R. I. M., Silva, P. R. S., Jannes, C. E., Pereira, A. C., Krieger, J. E., Nasir, K., & Santos, R. D. (2018) · JACC. Cardiovascular imaging · doi:10.1016/j.jcmg.2018.09.019 · Cited by 152 · see citing works
“Baseline cholesterol-years score 11,633 (7,330) 9,663 (5,313) 13,203 (9,462) 15,272 (5,633) <0.”
BackgroundSelf-citationTargeted proteomics improves cardiovascular risk prediction in secondary prevention
Nurmohamed, N. S., Pereira, J. P. B., Hoogeveen, R. M., Kroon, J., Kraaijenhof, J. M., Waissi, F., Timmerman, N., Bom, M. J., Hoefer, I. E., Knaapen, P., et al. (2022) · European Heart Journal · doi:10.1093/eurheartj/ehac055 · Cited by 148 · see citing works
Improved cardiovascular risk prediction using targeted plasma proteomics in primary prevention
Hoogeveen, R. M., Pereira, J. P. B., Nurmohamed, N. S., Zampoleri, V., Bom, M. J., Baragetti, A., Boekholdt, S. M., Knaapen, P., Khaw, K., Wareham, N. J., et al. (2020) · European Heart Journal · doi:10.1093/eurheartj/ehaa648 · Cited by 130 · see citing works
Mortensen, M. B., Gaur, S., Frimmer, A., Bøtker, H. E., Sørensen, H. T., Kragholm, K. H., Peter, S. R. N., Steffensen, F. H., Jensen, R. V., Mæng, M., et al. (2021) · JAMA Cardiology · doi:10.1001/jamacardio.2021.4406 · Cited by 130 · see citing works
Self-citationMach, F., Baigent, C., Catapano, A. L., Koskinas, K. C., Casula, M., Badimon, L., Chapman, M. J., De Backer, G. G., Delgado, V., Ference, B. A., et al. (2020) · European Heart Journal · doi:10.1093/eurheartj/ehz455 · Cited by 8,961 · see citing works
Evaluation of cardiovascular risk in a lung cancer screening cohort
Ruparel, M., Quaife, S. L., Dickson, J. L., Horst, C., Burke, S. J., Taylor, M. N., Ahmed, A., Shaw, P. J., Soo, M., Nair, A., et al. (2019) · Thorax · doi:10.1136/thoraxjnl-2018-212812 · Cited by 94 · see citing works
Proteomics-Enabled Deep Learning Machine Algorithms Can Enhance Prediction of Mortality
Unterhuber, M., Kresoja, K., Rommel, K., Besler, C., Baragetti, A., Klöting, N., Ceglarek, U., Blüher, M., Scholz, M. R., Catapano, A. L., et al. (2021) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2021.08.018 · Cited by 69 · see citing works
Coronary Artery Calcium Versus Pooled Cohort Equations Score for Primary Prevention Guidance
Muhlestein, J. B., Knowlton, K. U., Le, V. T., Lappe, D. L., May, H. T., Min, D. B., Johnson, K. M., Cripps, S. T., Schwab, L. H., Braun, S. B., et al. (2022) · JACC: Cardiovascular Imaging · doi:10.1016/j.jcmg.2021.11.006 · Cited by 57 · see citing works
The Effects of Warfarin and Direct Oral Anticoagulants on Systemic Vascular Calcification: A Review
Elango, K., Javaid, A. I., Khetarpal, B. K., Ramalingam, S., Kolandaivel, K. P., Gunasekaran, K., & Ahsan, C. H. (2021) · Cells · doi:10.3390/cells10040773 · Cited by 54 · see citing works
Kukharchuk, V. V., Владиславович, Е. М., Викторович, С. И., Arabidze, G. G., Balakhonova, T. V., Gurevich, V. S., Zelveyan, P. A., Murataliev, T. M., Myrzakhmetova, G., Александровна, С. О., et al. (2020) · Eurasian heart journal · doi:10.38109/2225-1685-2020-2-6-29 · Cited by 48 · see citing works
Fresno, C. M. U., Tijmes, F. S., Thavendiranathan, P., Akhtari, S., Karur, G. R., Torres, F. S., Halankar, J., Nguyen, E. T., & Hanneman, K. A. (2022) · American Journal of Roentgenology · doi:10.2214/ajr.22.27664 · Cited by 37 · see citing works
Vascular and valvular calcification biomarkers
Clemente, A., Traghella, I., Mazzone, A., Sbrana, S., & Vassalle, C. (2020) · Advances in clinical chemistry · doi:10.1016/bs.acc.2019.08.002 · Cited by 35 · see citing works
Ueng, K., Chiang, C., Chao, T., Wu, Y., Lee, W.-L., Li, Y., Ting, K.-H., Su, C.-H., Lin, H., Su, T., et al. (2023) · PubMed Central · doi:10.6515/acs.202301_39(1).20221103a · Cited by 34 · see citing works
Rijlaarsdam-Hermsen, D., Lo-Kioeng-Shioe, M., Kuijpers, D., van Domburg, R. T., Deckers, J. W., & van Dijkman, P. R. M. (2019) · Netherlands Heart Journal · doi:10.1007/s12471-019-01335-7 · Cited by 27 · see citing works
The Role of Statins in Current Guidelines
Rached, F. H., & Santos, R. D. (2020) · Current Atherosclerosis Reports · doi:10.1007/s11883-020-00861-9 · Cited by 29 · see citing works
Alsayed, N., Almahmeed, W. A., Alnouri, F., Al-Waili, K., Sabbour, H. M., Sulaiman, K., Zubaid, M., Ray, K. K., & Al‐Rasadi, K. (2021) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2021.11.022 · Cited by 23 · see citing works
Lai, R., Ju, J., Lin, Q., & Xu, H. (2020) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2020.600497 · Cited by 19 · see citing works
Coronary Artery Calcium Testing—Too Early, Too Late, Too Often
Zheutlin, A. R., Chokshi, A. K., Wilkins, J. T., & Stone, N. J. (2025) · JAMA Cardiology · doi:10.1001/jamacardio.2024.5644 · Cited by 20 · see citing works
Ružičić, D., Dobric, M. R., Vuković, M., Hrnčić, D., Đorđević, S., Ružičić, M., Aleksandric, S. B., Đorđević-Dikić, A., & Beleslin, B. (2017) · Clinical Radiology · doi:10.1016/j.crad.2017.12.002 · Cited by 18 · see citing works
Mortensen, M. B., Steffensen, F. H., Bøtker, H. E., Jensen, J. M., Sand, N. P. R., Kragholm, K. H., Kanstrup, H., Sørensen, H. T., Leipsic, J. A., Blaha, M. J., et al. (2020) · JACC. Cardiovascular imaging · doi:10.1016/j.jcmg.2020.03.017 · Cited by 18 · see citing works
Self-citationSubclinical cardiovascular disease and utility of coronary artery calcium score
Saydam, C. D. (2021) · IJC Heart & Vasculature · doi:10.1016/j.ijcha.2021.100909 · Cited by 17 · see citing works
Kadoglou, N. P. E., Stasinopoulou, M., Velidakis, N., Khattab, E., Christodoulou, E., Gkougkoudi, E., & Valsami, G. N. (2024) · Reviews in Cardiovascular Medicine · doi:10.31083/j.rcm2502051 · Cited by 16 · see citing works
“It is a widely known, valid, approach and has been endorsed by all recent international guidelines for major cardiovascular risk assessment [68].”
Nasir, K., Mszar, R., Cainzos‐Achirica, M., Grandhi, G. R., Tromp, T. R., Rodrigo Alonso, K., Bittencourt, M. S., Bruckert, É., Díaz-Díaz, J. L., Gallo, A., et al. (2023) · American Journal of Preventive Cardiology · doi:10.1016/j.ajpc.2023.100611 · Cited by 15 · see citing works
“Absence of CAC (CAC = 0) is a negative risk marker that can accurately predict low MACE risk in primary prevention settings [12,13].”
BackgroundSelf-citationEgyptian practical guidance in lipid management 2020
Taha, H., Badran, H. M., Kandil, H., Farag, N. M., Oraby, A., Sharkawy, M. E., Shokry, K., Fawzy, F., Mahrous, H. A., Bahgat, J., et al. (2021) · The Egyptian Heart Journal · doi:10.1186/s43044-021-00140-1 · Cited by 15 · see citing works
“score assessment on computed tomography (CT) might be considered as risk changers in persons at low or moderate risk [7].”
BackgroundAndersen, M. H., Jensen, J. M., Kanstrup, H., Sand, N. P. R., Busk, M., Hansen, M. K., Thrane, P. G., Olesen, K. K. W., Nordestgaard, B. G., Blaha, M. J., et al. (2025) · European Heart Journal · doi:10.1093/eurheartj/ehaf497 · Cited by 13 · see citing works
Self-citationForzano, I., Florimonte, D., Narciso, V., Canonico, M. E., Castiello, D. S., Manzi, L., Cristiano, S., Spinelli, A. M., Vallone, D. M., D’Alconzo, D., et al. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14238334 · Cited by 16 · see citing works
“These effects have been shown in vitro and in experimental systems, but their clinical relevance remains unproven [74,75].”
Matyas, B., Benedek, I., Raț, N., Gerculy, R., & Benedek, T. (2026) · Medicina · doi:10.3390/medicina62040630 · Cited by 13 · see citing works
“Furthermore, these high-risk phenotypes frequently occur in younger individuals and in patients with zero coronary artery calcium (CAC) scores, underscoring the limitations of CAC as a standalone indicator of risk [27–29].”
The new European guidelines for prevention of cardiovascular disease are misleading
Ravnskov, U., Alabdulgader, A., de Lorgeril, M., Diamond, D. M., Hama, R., Hamazaki, T., Hammarskjöld, B., Harcombe, Z., Kendrick, M. E., Langsjoen, P. H., et al. (2020) · Expert Review of Clinical Pharmacology · doi:10.1080/17512433.2020.1841635 · Cited by 13 · see citing works
Is There a Role of Coronary CTA in Primary Prevention? Current State and Future Directions
Mortensen, M. B., & Blaha, M. J. (2021) · Current Atherosclerosis Reports · doi:10.1007/s11883-021-00943-2 · Cited by 12 · see citing works
Self-citationSubclinical Atherosclerosis to Guide Treatment in Dyslipidemia and Diabetes Mellitus
Mszar, R., Katz, M. E., Grandhi, G. R., Osei, A. D., Gallo, A., & Blaha, M. J. (2024) · Current Atherosclerosis Reports · doi:10.1007/s11883-024-01202-w · Cited by 11 · see citing works
Self-citationKoopman, M. Y., Reijnders, J. J. W., Willemsen, R. T. A., van Bruggen, R., Doggen, C. J. M., Kietselaer, B., Wolcherink, M. J. O., van Ooijen, P. M. A., Gratama, J. W., Braam, R. L., et al. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-055123 · Cited by 10 · see citing works
Pasteur‐Rousseau, A., & Sebag, F. A. (2020) · Annales de Cardiologie et d Angéiologie · doi:10.1016/j.ancard.2020.09.028 · Cited by 10 · see citing works
Imaging subclinical coronary atherosclerosis to guide lipid management, are we there yet?
Piña, P., Lorenzatti, D., Paula, R., Daich, J., Schenone, A. L., Gongora, C. A., Garcia, M. J., Blaha, M. J., Budoff, M. J., Berman, D. S., et al. (2022) · American Journal of Preventive Cardiology · doi:10.1016/j.ajpc.2022.100451 · Cited by 10 · see citing works
“These results are based on an average relative risk reduction of 30% for statin therapy in the referenced primary prevention trials [129].”
BackgroundSelf-citationProgress in Cardiovascular Imaging
Shaw, L. J., & Chandrashekhar, Y. (2019) · JACC. Cardiovascular imaging · doi:10.1016/j.jcmg.2019.11.002 · Cited by 9 · see citing works
Владиславович, Е. М., Kukharchuk, V. V., Balakhonova, T. V., Gurevich, V. S., Сергиенко, И. В., Sokolov, A. A., Анатольевич, С. А., Иосифович, Ш. И., Ахмеджанов, Н. М., Барбараш, О. Л., et al. (2025) · Eurasian heart journal · doi:10.38109/2225-1685-2025-2-6-34 · Cited by 10 · see citing works
Lorea, A. E., Ruiz, M. V., de Esteban, J. P. M., Torres, J. G., Artajo, J. D. C., & Anda, E. (2025) · Acta cardiologica. Supplementum · doi:10.1080/00015385.2025.2597126 · Cited by 8 · see citing works
Imaging to Stratify Coronary Artery Disease Risk in Asymptomatic Patients with Diabetes
Malahfji, M., & Mahmarian, J. J. (2018) · Methodist DeBakey Cardiovascular Journal · doi:10.14797/mdcj-14-4-266 · Cited by 8 · see citing works
De-risking primary prevention: role of imaging
Shafter, A. M., Shaikh, K. A., Johanis, A., & Budoff, M. J. (2021) · Therapeutic Advances in Cardiovascular Disease · doi:10.1177/17539447211051248 · Cited by 7 · see citing works
Self-citationMortensen, M. B., Dzaye, O. D. A., Razavi, A. C., Jensen, J. M., Steffensen, F. H., Bøtker, H. E., Cainzos‐Achirica, M., Sørensen, H. T., Mæng, M., Blaha, M. J., et al. (2022) · European Journal of Preventive Cardiology · doi:10.1093/eurjpc/zwac104 · Cited by 7 · see citing works
Self-citationDunleavy, M. P., Guha, A., Cardona, A., Fortuna, C., Daoud, E. G., Raman, S. V., & Harfi, T. T. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9061631 · Cited by 7 · see citing works
Alieva, A. S., Usova, E., Звартау, Н. Э., & Shlyakhto, E. V. (2023) · Russian Journal of Cardiology · doi:10.15829/1560-4071-2024-5724 · Cited by 6 · see citing works
Kerut, E. K., Hall, M. E., Turner, M. C., & McMullan, M. R. (2018) · Echocardiography · doi:10.1111/echo.14091 · Cited by 6 · see citing works
Extensive Coronary Artery Calcifications
Blankstein, R., & Chandrashekhar, Y. (2020) · JACC. Cardiovascular imaging · doi:10.1016/j.jcmg.2019.12.007 · Cited by 6 · see citing works
“CAC of >100 (4,7), >300 (8,9) or >400 (2,5) were noted thresholds for high risk in various studies.”
BackgroundMiyoshi, T., Osawa, K., Ichikawa, K., Suruga, K., Miki, T., Yoshida, M., Nakagawa, K., Toda, H., Nakamura, K., Morita, H., et al. (2019) · Current Cardiology Reports · doi:10.1007/s11886-019-1170-4 · Cited by 5 · see citing works
Preoperative statin therapy for adults undergoing cardiac surgery
Antunes, M. M., Nunes-Ferreira, A., Duarte, G. S., Melo, R. G. E., Rodrigues, B. S., Guerra, N. C., Nobre, Â. L., Pinto, F. J., Costa, J. G., & Caldeira, D. (2024) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008493.pub5 · Cited by 6 · see citing works
Luo, F., Luo, J., Liu, F., Qiu, Y., Tian, X., Zeng, L., Zhang, Z., Li, X., & Yang, Y. (2022) · Clinical Cardiology · doi:10.1002/clc.23959 · Cited by 5 · see citing works
“classified into two groups: those with CACS < 100 and those with CACS ≥ 100.(17)”
BackgroundPreventative Imaging with Coronary Computed Tomography Angiography
Antonopoulos, A. S., & Simantiris, S. (2023) · Current Cardiology Reports · doi:10.1007/s11886-023-01982-8 · Cited by 6 · see citing works
Martínez‐Doménech, Á., Giner, J. F. G. F., Pérez-Pastor, G. M., Magdaleno‐Tapial, J., Herraez-Cervera, B., Sánchez‐Carazo, J. L., Martínez-León, J., & Pérez‐Ferriols, A. (2022) · Actas Dermo-Sifiliográficas · doi:10.1016/j.ad.2022.04.013 · Cited by 4 · see citing works
What Is of Recent Interest in Cardiac CT
Chandrashekhar, Y. (2019) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2019.05.033 · Cited by 4 · see citing works
Raggi, P., Prandini, N., Ligabue, G., Braglia, G., Esposito, F., Milić, J., Malagoli, A., Scaglioni, R., Besutti, G., Beghetto, B., et al. (2019) · International Journal of Molecular Sciences · doi:10.3390/ijms20051183 · Cited by 4 · see citing works
Zhu, L., Cui, Q., Liu, Y., Liu, Z., Zhang, Y., Liu, F., & Wang, J. (2020) · Medical Science Monitor · doi:10.12659/msm.925114 · Cited by 4 · see citing works
Douthit, N. T., Wyatt, N. E., & Schwartz, B. H. (2021) · Cureus · doi:10.7759/cureus.14856 · Cited by 4 · see citing works
“CAC scans may assist in decreasing the number of statins prescribed, but if ordered to make that determination, it would not improve healthcare costs [13].”
BackgroundJukema, R., Nasibi, N., Mueller, A. S., Kim, S., Argulian, E., Khoo, J. K., Binzaid, A. A., Rigby, H., Pashaee, B., Danad, I., et al. (2025) · Journal of cardiovascular computed tomography · doi:10.1016/j.jcct.2025.08.008 · Cited by 3 · see citing works
The Role of Statins in Prevention of Cardiovascular Diseases in Real Clinical Practice
IuA, K., & Moscow, R. F. (2021) · Doctor Ru · doi:10.31550/1727-2378-2021-20-11-17-27 · Cited by 3 · see citing works
Škorić, B. (2021) · Cardiologia Croatica · doi:10.15836/ccar2021.87 · Cited by 3 · see citing works
Coronary calcium is all we need for risk assessment, yet we do not use it often enough
Raggi, P. (2019) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2019.01.018 · Cited by 3 · see citing works
Coronary Artery Calcium Scoring Improves Allocation of the GLP-1 Receptor Agonist Semaglutide
Kloner, R. A., & Budoff, M. J. (2025) · JACC. Cardiovascular imaging · doi:10.1016/j.jcmg.2024.10.007 · Cited by 3 · see citing works
Self-citationCoronary Artery Calcium (CAC) Imaging as a Diagnostic Test
Naghavi, M., Wong, N. D., McConnell, M. V., Maron, D. J., Nasir, K., Henschke, C. I., Yankelevitz, D. F., Fayad, Z. A., Vliegenthart, R., Williams, K. A., Sr., et al. (2025) · JACC. Cardiovascular imaging · doi:10.1016/j.jcmg.2025.10.020 · Cited by 2 · see citing works
Self-citationTécnicas de imagen en aterosclerosis
Escobar, C., & de Isla, L. P. (2021) · Clínica e Investigación en Arteriosclerosis · doi:10.1016/j.arteri.2020.12.002 · Cited by 2 · see citing works
The Role of Coronary Artery Calcium Testing for Value-Based Clinical Trials in Primary Prevention
Fentanes, E., Cainzos‐Achirica, M., Nasir, K., & Blankstein, R. (2021) · Current Atherosclerosis Reports · doi:10.1007/s11883-021-00969-6 · Cited by 2 · see citing works
Self-citationAshikhmin, Y. I., Sinitsyn, V. E., Plieva, N. V., Shchekochikhin, D., & Kopylov, F. Y. (2019) · Kardiologiia · doi:10.18087/cardio.2019.6.n685 · Cited by 2 · see citing works
Blumenthal, R. S., Aslam, M., & McEvoy, J. W. (2017) · JACC. Cardiovascular imaging · doi:10.1016/j.jcmg.2017.02.019 · Cited by 2 · see citing works
“(4) should be congratulated for demonstrating that selective use of a CAC scan can truly identify those individuals who are at very low risk and those who are at significantly higher long-term risk, something that no other risk assessment strategies available to us appear able to do.”
BackgroundResultInfluentialMartínez‐Doménech, Á., Giner, J. F. G. F., Pérez-Pastor, G. M., Magdaleno‐Tapial, J., Herraez-Cervera, B., Sánchez‐Carazo, J. L., Martínez-León, J., & Pérez‐Ferriols, A. (2022) · Actas Dermo-Sifiliográficas · doi:10.1016/j.ad.2022.04.016 · Cited by 1 · see citing works
Raggi, P., Bellasi, A., & Alexopoulos, N. A. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-816389-4.00006-2 · Cited by 1 · see citing works
Raggi, P., & Bellasi, A. (2020) · Springer eBooks · doi:10.1007/978-3-030-57460-4_2 · Cited by 1 · see citing works
Kerut, E. K., Hebert, R. L., Hall, M. E., Turner, M. C., & McMullan, M. R. (2018) · Echocardiography · doi:10.1111/echo.14099 · Cited by 1 · see citing works
Risk scores and primary prevention
Özdoğan, Ö. (2020) · Updates in Cardiology · doi:10.5543/ucard.2019.69188 · Cited by 1 · see citing works
“[7,8] Asemptomatik düşük ve orta riskli hastaların bi-rincil korunmasında görüntüleme ile aterosklerotik Birincil tedavisi stratejisi açısından karşılaştırıldığın-da, kalsiyum skorunun uzun dönem statin tedavisi ge-rektiren hastaların saptanmasında kullanılması mali-yet-etkin olacaktır.”
Comments on the 2019 ESC/EAS guidelines for the management of dyslipidemias
de Isla, L. P., Masana, L., Argüeso, R. M., Campuzano, R., Egocheaga, I., Escobar, C., Fácila, L., López, P. M., Rossi, M., Mansilla, C. R., et al. (2020) · Revista Española de Cardiología (English Edition) · doi:10.1016/j.rec.2019.11.019 · Cited by 1 · see citing works
Cesena, F. Y., & Bittencourt, M. S. (2018) · Current Cardiovascular Risk Reports · doi:10.1007/s12170-018-0591-8
Sánchez Vega, J. D., & Zamorano Gómez, J. L. (2019) · Revista Uruguaya de Cardiología · doi:10.29277/cardio.34.3.27
Mahmarian, J. J. (2020) · Journal of Nuclear Cardiology · doi:10.1007/s12350-020-02086-4
Atherosclerosis and Oncology: Shared Mechanisms, Shared Treatment Principles
Danciu, S. C., & Campos, E. P. (2020) · Annals of Clinical Cardiology · doi:10.4103/accj.accj_8_20
New approaches to managing patients with high total risk (review of year 2019 recommendations)
Nv, O., Витальевна, П. Т., Laperishvili, М. A., & GOryaynOva, S. V. (2020) · Medical alphabet · doi:10.33667/2078-5631-2020-2-24-28
Forecasting Preventive Care Effectiveness With Imaging
Shaw, L. J., Blankstein, R., & Chandrashekar, Y. (2020) · JACC. Cardiovascular imaging · doi:10.1016/j.jcmg.2020.08.003
Escobar, C., & Barrios, V. (2020) · Revista Española de Cardiología Suplementos · doi:10.1016/s1131-3587(20)30026-1
Comentarios a la guía ESC/EAS 2019 sobre el tratamiento de las dislipemias
Grupo de Trabajo de la SEC para la guía ESC 2019 sobre el tratamiento de las dislipemias, R. E. P. L. G. E. 2. S. E. T. D. L. D. Y. C. D. G. D. L. S. (2020) · Revista Española de Cardiología · doi:10.1016/j.recesp.2019.11.009
Anticholesterol activities of the microalgae
Hamouda, R. A., Abuelmagd, M. A., Alhumairi, A. M., & El‐Bialy, B. E. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-22080-7.00040-5
CT coronary angiography in the lipid clinic: a pilot study and lipidologist survey
Graby, J., Sellek, J., Khavandi, A., Thompson, D., Loughborough, W. W., Hudson, B. J., Avades, T. Y., Mbagaya, W., Luvai, A., Capps, N. E., et al. (2025) · The International Journal of Cardiovascular Imaging · doi:10.1007/s10554-025-03526-3
Abdelaal, A. M., Ghonem, M., Mohamed, Y. A., Hasan, A. S., & Kyrillos, F. A. (2026) · BMC Endocrine Disorders · doi:10.1186/s12902-026-02242-w
“Although the reduction of Low-density Lipoprotein (LDL) levels is the major effect of statins, many other pleiotropic effects have been suggested (anti-inflammatory and antioxidant effects) [6, 7].”
Calcium Density as a Marker of Coronary Plaque Stabilization in Primary Prevention
Vasanthakumar, S. A., Nicholls, S. J., Nerlekar, N., Marwick, T. H., & Lin, A. (2026) · JACC. Cardiovascular imaging · doi:10.1016/j.jcmg.2026.07.029
- Authors
- Mortensen, M. B., Falk, E., Li, D., Nasir, K., Blaha, M. J., Sandfort, V., Rodriguez, C. J., Ouyang, P., & Budoff, M.
- Affiliations
- Aarhus University Hospital (DK)
- University of California, Los Angeles (US)
- Johns Hopkins University (US)
- National Institutes of Health (US)
- Wake Forest University Health Sciences (US)
- Corresponding author
- Mortensen, Martin Bødtker
- ORCID
- Venue
- JACC: Cardiovascular Imaging
- Publisher
- Elsevier BV
- Published
- 2018-02
- Volume
- 11
- Issue
- 2
- Pages
- 221-230
- ISSN
- 1876-7591 (ISSN-L)
- 1936-878X
- PMC
- PMC5723240
- OpenAlex
- W2730247497
- Cited by
- 88
- References
- 46
- Citations by year
- 2026: 3 · 2025: 10 · 2024: 3 · 2023: 5 · 2022: 9 · 2021: 15 · 2020: 20 · 2019: 12 · 2018: 8 · 2017: 2 · 2016: 1
- FWCI
- 11.76
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- JACC. Cardiovascular imaging (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- Regeneron Pharmaceuticals
- National Institutes of Health (n01hc95164-17-0-1, n01hc95165-34-0-1, n01hc95161-24-0-1, n01hc095169-003, n01hc95166-21-0-1, n01hc95162-31-0-1, n01hc95168-27-0-1, n01hc95160-18-0-1, n01hc095167-000, UL1TR001079, n01hc95163-22-0-1, n01hc95159-40-0-1, UL1TR000040)
- National Heart, Lung, and Blood Institute (N01-HC095169, N01-HC-095165, N01 HC095163, N01-HC-095159, N01 HC095168, N01-HC-095162, N01-HC-095161, HHSN268201500003C, HHSN26820150 0003I, N01 HC095167, N01-HC-095160, N01 HC095166, N01 HC095164)
- National Center for Research Resources (N01-HC-95168, N01 HC 95169)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Keywords
- coronary artery calcium, statin therapy, primary prevention, atherosclerotic cardiovascular disease, coronary artery disease, number needed to treat, cardiovascular risk stratification, shared decision-making, MESA
- MeSH terms
- Clinical Decision-Making, Aged, Aged, 80 and over, Coronary Artery Disease, Female, Humans, Male, Middle Aged, Primary Prevention, Risk Factors, Time Factors, United States, Randomized Controlled Trials as Topic, Treatment Outcome, Coronary Angiography, Patient Selection, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Evidence-Based Medicine, Dyslipidemias, Vascular Calcification
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
