ArticleJournal of the American College of Cardiology2020
Impact of Plaque Burden Versus Stenosis on Ischemic Events in Patients With Coronary Atherosclerosis.
Article in Journal of the American College of Cardiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 129 papers, 2 of them syntheses that pooled it.
What it found
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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.
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.
Dapagliflozin Effects on Coronary Calcium and Epicardial Fat Assessed by Cardiotomography
Open the trial in the graphEffect of PCSK9 Inhibitors on Coronary Atherosclerotic Plaques Derived From Optical Coherence Tomography in Patients With Premature Coronary Artery Disease: a Randomized Controlled Trial
Who cites it
129 citing papers in PubMed, 2 syntheses or guidelines pooled it, 262 citations in OpenAlex.
- Assessment of Subclinical Atherosclerosis in Asymptomatic People In Vivo: Measurements Suitable for Biomarker and Mendelian Randomization Studies.Arteriosclerosis, thrombosis, and vascular biology · 2024Pooled it
- Association of Obstructive Sleep Apnea Syndrome (OSA/OSAHS) with Coronary Atherosclerosis Risk: Systematic Review and Meta-Analysis.Computational and mathematical methods in medicine · 2022Pooled it
- Allocation of Semaglutide According to Coronary Artery Calcium and BMI: Applying the SELECT Trial to MESA.JACC. Cardiovascular imaging · 2025Trial
- Coronary microvascular function and atherosclerotic plaque burden in ischaemia and no obstructive coronary arteries: a secondary analysis of the CorMicA trial.Heart (British Cardiac Society) · 2025Trial
- Redefining NSTE-ACS risk assessment: The synergistic power of CT-enhanced GRACE 2.0 score for advanced prognosis.The international journal of cardiovascular imaging · 2026Article
- Single-cell transcriptomics uncovers endothelial progenitor-like remodelling driving human coronary atherosclerosis progression.Nature cell biology · 2026Article
- Long-term prognostic impact of complete revascularisation defined by CT-derived fractional flow reserve.Heart (British Cardiac Society) · 2026Article
- Clinical use of coronary computed tomography angiography-derived fractional flow reserve: expert consensus by an International Working Group.European radiology · 2026Article
- Artificial intelligence-based coronary computed tomography angiography quantification of atherosclerosis burden: comparison with intravascular ultrasound in the INVICTUS Registry.European radiology · 2026Article
- Real-world insights into coronary CTA prognostication: value of semiquantitative scores.La Radiologia medica · 2026Article
- Association of AI-assisted quantitative coronary plaque burden and CT-derived fractional flow reserve with major adverse cardiovascular events.BMC medical imaging · 2026Article
- Article
- CAD-RADS 2.0: Comparison of methods for assessment of plaque burden.European journal of radiology open · 2026Article
- Coronary Artery Calcium Score Predicts Cardiovascular and Transplant-Related Outcomes in Lung Transplant Recipients.Clinical transplantation · 2026Article
- Development and validation of a novel deep learning coronary artery plaque quantification model.BMC medical imaging · 2026Article
- Association of insulin resistance and positive coronary artery remodeling and plaque burden in patients with acute coronary syndrome.BMC cardiovascular disorders · 2026Article
- Coronary plaque burden as a determinant of cardiovascular outcomes in patients undergoing percutaneous coronary intervention versus coronary artery bypass grafting: The Western Denmark Heart Registry.American journal of preventive cardiology · 2026Article
- Quantitative Coronary Atherosclerotic Plaque Burden From CCTA and the Benefit From Lipid-Lowering Medication.Circulation. Cardiovascular imaging · 2026Observational
- Predictors of diffuse coronary artery calcium phenotype in adults aged ≥ 75: The Atherosclerosis Risk in Communities (ARIC) study.American journal of preventive cardiology · 2026Article
- The time-varying prognostic value of stenosis and plaque burden in coronary artery disease.European heart journal. Cardiovascular Imaging · 2026Article
69 more citing papers are in PubMed but not listed here.
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Authors and funding
12 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients with obstructive coronary artery disease (CAD) are at high risk for cardiovascular disease (CVD) events. However, it remains unclear whether the high risk is due to high atherosclerotic disease burden or if presence of stenosis has independent predictive value.
objectivesThe purpose of this study was to evaluate if obstructive CAD provides predictive value beyond its association with total calcified atherosclerotic plaque burden as assessed by coronary artery calcium (CAC).
methodsAmong 23,759 symptomatic patients from the Western Denmark Heart Registry who underwent diagnostic computed tomography angiography (CTA), we assessed the risk of major CVD (myocardial infarction, stroke, and all-cause death) stratified by CAC burden and number of vessels with obstructive disease.
resultsDuring a median follow-up of 4.3 years, 1,054 patients experienced a first major CVD event. The event rate increased stepwise with both higher CAC scores and number of vessels with obstructive disease (by CAC scores: 6.2 per 1,000 person-years (PY) for CAC = 0 to 42.3 per 1,000 PY for CAC >1,000; by number of vessels with obstructive disease: 6.1 per 1,000 PY for no CAD to 34.7 per 1,000 PY for 3-vessel disease). When stratified by 5 groups of CAC scores (0, 1 to 99, 100 to 399, 400 to 1,000, and >1,000), the presence of obstructive CAD was not associated with higher risk than presence of nonobstructive CAD.
conclusionsPlaque burden, not stenosis per se, is the main predictor of risk for CVD events and death. Thus, patients with a comparable calcified atherosclerosis burden generally carry a similar risk for CVD events regardless of whether they have nonobstructive or obstructive CAD.
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What Socratic holds
Registered trials
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 Socratic graph.