The DOI matches its Crossref record; 38 of the 38 references it cites were found in a registry or an index.
Prognostic Value of Cardiac Risk Factors and Coronary Artery Calcium Screening for All-Cause Mortality
Abstract
PURPOSE: To develop risk-adjusted multivariable models that included risk factors and coronary calcium scores determined with electron-beam computed tomography (CT) in asymptomatic patients for the prediction of all-cause mortality. MATERIALS AND METHODS: We followed up a cohort of 10,377 asymptomatic individuals undergoing cardiac risk factor evaluation and coronary calcium screening with electron-beam CT. Multivariable Cox proportional hazards models were developed to predict all-cause mortality. Risk-adjusted models incorporated traditional risk factors for coronary disease and coronary calcium scores. RESULTS: Cardiac risk factors such as family history of coronary disease (69%), hypercholesterolemia (62%), hypertension (44%), smoking (40%), and diabetes (9%) were prevalent. The frequency of coronary calcium scores was 57%, 20%, 14%, 6%, and 3% for scores of 10 or less, 11-100, 101-400, 401-1,000, and greater than 1,000, respectively. During a mean follow-up of 5.0 years +/- 0.0086 (standard error of the mean), the death rate was 2.4%. In a risk-adjusted model (model chi2 = 388.2, P <.001), coronary calcium was an independent predictor of mortality (P <.001). Risk-adjusted relative risk values for coronary calcium were 1.64, 1.74, 2.54, and 4.03 for scores of 11-100, 101-400, 401-1,000, and greater than 1,000, respectively (P <.001 for all values), as compared with that for a score of 10 or less. Five-year risk-adjusted survival was 99.0% for a calcium score of 10 or less and 95.0% for a score of greater than 1,000 (P <.001). With a receiver operating characteristic curve, the concordance index increased from 0.72 for cardiac risk factors alone to 0.78 (P <.001) when the calcium score was added to a multivariable model for prediction of death. CONCLUSION: This large observational data series shows that coronary calcium provides independent incremental information in addition to traditional risk factors in the prediction of all-cause mortality.
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Cites
Expert Panel on Detection, E. (2001) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.285.19.2486 · Cited by 26,011
Prediction of coronary heart disease using risk factor categories
Wilson, P. W. F., D’Agostino, R. B., Levy, D., Belanger, A. M., Silbershatz, H., & Kannel, W. B. (1998) · Circulation · doi:10.1161/01.cir.97.18.1837 · Cited by 9,581
Quantification of coronary artery calcium using ultrafast computed tomography
Agatston, A. S., Janowitz, W. R., Hildner, F. J., Zusmer, N. R., Viamonte, M., & Detrano, R. (1990) · Journal of the American College of Cardiology · doi:10.1016/0735-1097(90)90282-t · Cited by 7,786
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
The Pathogenesis of Coronary Artery Disease and the Acute Coronary Syndromes
Epstein, F. H., Fuster, V., Badimon, L., Badimon, J. J., & Chesebro, J. H. (1992) · New England Journal of Medicine · doi:10.1056/nejm199201303260506 · Cited by 3,725
The Pathogenesis of Coronary Artery Disease and the Acute Coronary Syndromes
Epstein, F. H., Fuster, V., Badimon, L., Badimon, J. J., & Chesebro, J. H. (1992) · New England Journal of Medicine · doi:10.1056/nejm199201233260406 · Cited by 2,717
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Farb, A., Burke, A. P., Tang, A. L., Liang, Y., Mannan, P., Smialek, J., & Virmani, R. (1996) · Circulation · doi:10.1161/01.cir.93.7.1354 · Cited by 1,276
Cited by
Coronary Calcium as a Predictor of Coronary Events in Four Racial or Ethnic Groups
Detrano, R., Guerci, A. D., Carr, J. J., Bild, D. E., Burke, G., Folsom, A. R., Liu, K., Shea, S., Szklo, M., Bluemke, D. A., et al. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa072100 · Cited by 2,989
Cancer risks from diagnostic radiology
HALL, E. J., & BRENNER, D. J. (2008) · The British Journal of Radiology · doi:10.1259/bjr/01948454 · Cited by 915
Prognostic value of coronary artery calcium screening in subjects with and without diabetes
Raggi, P., Shaw, L. J., Berman, D. S., & Callister, T. Q. (2004) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2003.09.068 · Cited by 608
Self-citationVascular calcifications as a marker of increased cardiovascular risk: A meta-analysis
Rennenberg, R., Kessels, Schurgers, Engelshoven, V., de Leeuw, P., & Kroon (2009) · Vascular Health and Risk Management · doi:10.2147/vhrm.s4822 · Cited by 469
Impact of Coronary Artery Calcium Scanning on Coronary Risk Factors and Downstream Testing
Rozanski, A., Gransar, H., Shaw, L. J., Kim, J., Miranda-Peats, L., Wong, N. D., Rana, J. S., Orakzai, R., Hayes, S. W., Friedman, J. D., et al. (2011) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2011.01.019 · Cited by 458
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Metadata
- Authors
- Shaw, L. J., Raggi, P., Schisterman, E., Berman, D. S., & Callister, T. Q.
- Venue
- Radiology
- Published
- 2003-09
- Volume
- 228
- Issue
- 3
- Pages
- 826-833
- ISSN
- 0033-8419 (ISSN-L)
- 1527-1315
- OpenAlex
- W2151599748
- Cited by
- 891
- References
- 38
- FWCI
- 47.85
- Type
- journal article
- Language
- en
- Open access
- closed
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