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Cited by 425

The DOI matches its Crossref record; 52 of the 52 references it cites were found in a registry or an index.

Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population

Open access
Bergström, Göran, Persson, Margaretha, Adiels, Martin, Björnson, Elias, Bonander, Carl, Ahlström, Håkan, Alfredsson, Joakim, Angerås, Oskar, Berglund, Göran, Blomberg, Anders, Brandberg, John, Börjesson, Mats, Cederlund, Kerstin, de Faire, Ulf, Duvernoy, Olov, Ekblom, Örjan, Engström, Gunnar, Engvall, Jan E., Fagman, Erika, Eriksson, Mats, Erlinge, David, Fagerberg, Björn, Flinck, Agneta, Gonçalves, Isabel, Hagström, Emil, Hjelmgren, Ola, Lind, Lars, Lindberg, Eva, Lindqvist, Per, Ljungberg, Johan, Magnusson, Martin, Mannila, Maria, Markstad, Hanna, Mohammad, Moman A., Nystrom, Fredrik H., Ostenfeld, Ellen, Persson, Anders, Rosengren, Annika, Sandström, Anette, Själander, Anders, Sköld, Magnus C., Sundström, Johan, Swahn, Eva, Söderberg, Stefan, Torén, Kjell, Östgren, Carl Johan, Jernberg, Tomas·2021·Circulation
DOI 10.1161/circulationaha.121.055340
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Abstract

Background: Early detection of coronary atherosclerosis using coronary computed tomography angiography (CCTA), in addition to coronary artery calcification (CAC) scoring, may help inform prevention strategies. We used CCTA to determine the prevalence, severity, and characteristics of coronary atherosclerosis and its association with CAC scores in a general population. Methods: We recruited 30 154 randomly invited individuals age 50 to 64 years to SCAPIS (the Swedish Cardiopulmonary Bioimage Study). The study includes individuals without known coronary heart disease (ie, no previous myocardial infarctions or cardiac procedures) and with high-quality results from CCTA and CAC imaging performed using dedicated dual-source CT scanners. Noncontrast images were scored for CAC. CCTA images were visually read and scored for coronary atherosclerosis per segment (defined as no atherosclerosis, 1% to 49% stenosis, or ≥50% stenosis). External validity of prevalence estimates was evaluated using inverse probability for participation weighting and Swedish register data. Results: In total, 25 182 individuals without known coronary heart disease were included (50.6% women). Any CCTA-detected atherosclerosis was found in 42.1%; any significant stenosis (≥50%) in 5.2%; left main, proximal left anterior descending artery, or 3-vessel disease in 1.9%; and any noncalcified plaques in 8.3% of this population. Onset of atherosclerosis was delayed on average by 10 years in women. Atherosclerosis was more prevalent in older individuals and predominantly found in the proximal left anterior descending artery. Prevalence of CCTA-detected atherosclerosis increased with increasing CAC scores. Among those with a CAC score >400, all had atherosclerosis and 45.7% had significant stenosis. In those with 0 CAC, 5.5% had atherosclerosis and 0.4% had significant stenosis. In participants with 0 CAC and intermediate 10-year risk of atherosclerotic cardiovascular disease according to the pooled cohort equation, 9.2% had CCTA-verified atherosclerosis. Prevalence estimates had excellent external validity and changed marginally when adjusted to the age-matched Swedish background population. Conclusions: Using CCTA in a large, random sample of the general population without established disease, we showed that silent coronary atherosclerosis is common in this population. High CAC scores convey a significant probability of substantial stenosis, and 0 CAC does not exclude atherosclerosis, particularly in those at higher baseline risk.

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Metadata

Authors
Bergström, G., Persson, M., Adiels, M., Björnson, E., Bonander, C., Ahlström, H., Alfredsson, J., Angerås, O., Berglund, G., Blomberg, A., Brandberg, J., Börjesson, M., Cederlund, K., de Faire, U., Duvernoy, O., Ekblom, Ö., Engström, G., Engvall, J. E., Fagman, E., Eriksson, M., Erlinge, D., Fagerberg, B., Flinck, A., Gonçalves, I., Hagström, E., Hjelmgren, O., Lind, L., Lindberg, E., Lindqvist, P., Ljungberg, J., Magnusson, M., Mannila, M., Markstad, H., Mohammad, M. A., Nystrom, F. H., Ostenfeld, E., Persson, A., Rosengren, A., Sandström, A., Själander, A., Sköld, M. C., Sundström, J., Swahn, E., Söderberg, S., Torén, K., Östgren, C. J., & Jernberg, T.
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2021-09-21
Volume
144
Issue
12
Pages
916-929
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/circulationaha.121.055340
OpenAlex
W3200704993
Cited by
425
References
52
FWCI
30.00
Type
journal article
Language
en
Open access
hybrid

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CoChat. (2026). Citation check: Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population. https://app.cochat.ai/papers/10.1161/circulationaha.121.055340
The paper
Bergström, G., Persson, M., Adiels, M., Björnson, E., Bonander, C., Ahlström, H., Alfredsson, J., Angerås, O., Berglund, G., Blomberg, A., Brandberg, J., Börjesson, M., Cederlund, K., de Faire, U., Duvernoy, O., Ekblom, Ö., Engström, G., Engvall, J. E., Fagman, E., . . . Jernberg, T. (2021). Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population. Circulation. https://doi.org/10.1161/circulationaha.121.055340

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Bibliographic data: Semantic Scholar, OpenAlex, Crossref.

Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.