Evidence map›Paper›PMID 41978316›Full record

Observational studyEuropean heart journal. Cardiovascular Imaging2026

Computed tomography derived segment involvement score and coronary artery calcium score when used in clinical routine-data from a Swedish Registry Cohort.

Henrik Löfmark, Ellen Ostenfeld, Tomasz Baron, Erika Fagman, Kari Feldt, Hanna Markstad, Josephine Muhrbeck, Mårten Sandstedt, Kambiz Shahgaldi, Eva Zelleroth and 2 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in European heart journal. Cardiovascular Imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Henrik LöfmarkDepartment of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm 182 88, Sweden.
Ellen OstenfeldDepartment of Medical Imaging and Physiology, Cardiac Imaging, Skåne University Hospital, Lund University, Lund, Sweden.ORCID 0000-0002-2655-2423
Tomasz BaronDepartment of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.ORCID 0000-0002-8290-557X
Erika FagmanDepartment of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Kari FeldtDepartment of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
Hanna MarkstadDepartment of Medical Imaging and Physiology, Cardiac Imaging, Skåne University Hospital, Lund University, Lund, Sweden.
Josephine MuhrbeckDepartment of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm 182 88, Sweden.
Mårten SandstedtDepartment of Radiology in Linköping and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Kambiz ShahgaldiDepartment of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm 182 88, Sweden.
Eva ZellerothDepartment of Medicine, Malarsjukhuset, Eskilstuna, Sweden.
David ErlingeDepartment of Clinical Sciences, Cardiology, Lund University, Lund, Sweden.
Tomas JernbergDepartment of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm 182 88, Sweden.ORCID 0000-0003-1695-379X

Funding

Swedish Heart-Lung Foundation 2024-1174Swedish Research Council 2024-03740
6 · The paper itself

Abstract

aimsThis study aimed to evaluate the prognostic value of segment involvement score (SIS) from coronary computed tomography angiography (CCTA) and compare it with coronary artery calcium score (CACS) in clinical practice. METHODS AND

resultsPatients undergoing CCTA for suspected coronary artery disease between 2006 and 2022 at 27 centres were included. SIS was defined by the number of segments with plaque. CACS was calculated using the Agatston method. Patients were followed for all-cause death and/or myocardial infarction (MI). A total of 23,034 patients were followed for a median of 2.5 years. SIS = 0 was found in 61.4% of patients, SIS = 1 in 12.6%, SIS = 2 in 8.2%, SIS = 3 in 5.7%, and SIS ≥ 4 in 12.2%. Compared with SIS = 0, SIS ≥ 4 was associated with higher adjusted risk of death (HR [95% CI]: 1.39 [1.17-1.66]), MI (3.53 [2.72-4.59]), and death or MI (1.88 [1.62-2.18]). Obstructive stenosis (≥50%) was also independently associated with all outcomes but showed lower discrimination than SIS in receiver operating characteristic curve analyses. SIS and CACS had similar ability to predict death or MI (Area under the curve: 0.70 [0.67-0.74] vs. 0.68 [0.65-0.72], P = 0.08) and MI alone (0.72 [0.67-0.77] vs. 0.72 [0.67-0.78], P = 0.69). CACS performed better than SIS in predicting death (0.70 [0.66-0.74] vs. 0.67 [0.63-0.70], P = 0.008).

conclusionBoth the extent of coronary atherosclerosis, measured by SIS, and the presence of obstructive disease are important predictors of outcomes. However, they do not provide additional prognostic value over CACS when used in routine clinical practice.

Indexed as

Computed Tomography AngiographyCoronary AngiographyCoronary Artery DiseaseVascular CalcificationAgedCohort StudiesFemaleHumansMaleMiddle AgedPrognosisRegistriesRisk AssessmentSeverity of Illness IndexSwedencalcium scorecoronary artery diseasecoronary computed tomography angiographysegmentation involvement score

Identifiers

PMID41978316
PMCPMC13314024

What Socratic holds

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LicenceCC BY
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Registered trials

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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.