{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T13:51:53Z","timestamp":1791813113518,"version":"4.3.4"},"reference-count":51,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","internationaljournalofcardiology.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Cardiology"],"published-print":{"date-parts":[[2020,1]]},"DOI":"10.1016\/j.ijcard.2019.06.003","type":"journal-article","created":{"date-parts":[[2019,6,4]],"date-time":"2019-06-04T02:44:01Z","timestamp":1559616241000},"page":"56-62","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":67,"special_numbering":"C","title":["Prognostic value of coronary artery calcium score in symptomatic individuals: A meta-analysis of 34,000 subjects"],"prefix":"10.1016","volume":"299","author":[{"given":"Mallory S.","family":"Lo-Kioeng-Shioe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1982-3547","authenticated-orcid":false,"given":"Dorine","family":"Rijlaarsdam-Hermsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron T.","family":"van Domburg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Hadamitzky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o A.C.","family":"Lima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanne E.","family":"Hoeks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaap W.","family":"Deckers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ijcard.2019.06.003_bb0005","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1016\/0735-1097(90)90282-T","article-title":"Quantification of coronary artery calcium using ultrafast computed tomography","volume":"15","author":"Agatston","year":"1990","journal-title":"J. Am. Coll. Cardiol."},{"key":"10.1016\/j.ijcard.2019.06.003_bb0010","article-title":"Comparison of coronary artery calcium presence, carotid plaque presence, and carotid intima-media thickness for cardiovascular disease prediction in the multi-ethnic study of atherosclerosis","volume":"8","author":"Gepner","year":"2014","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"10.1016\/j.ijcard.2019.06.003_bb0015","doi-asserted-by":"crossref","first-page":"1643","DOI":"10.1016\/j.jacc.2015.08.035","volume":"66","author":"McClelland","year":"2015","journal-title":"J. Am. Coll. Cardiol."},{"key":"10.1016\/j.ijcard.2019.06.003_bb0020","doi-asserted-by":"crossref","first-page":"S49","DOI":"10.1161\/01.cir.0000437741.48606.98","article-title":"2013 ACC\/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines","volume":"129","author":"Goff","year":"2014","journal-title":"Circulation"},{"key":"10.1016\/j.ijcard.2019.06.003_bb0025","doi-asserted-by":"crossref","first-page":"1761","DOI":"10.1161\/CIRCULATIONAHA.106.178458","volume":"114","author":"Budoff","year":"2006","journal-title":"Circulation"},{"key":"10.1016\/j.ijcard.2019.06.003_bb0030","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1016\/j.ijcard.2017.01.132","article-title":"Coronary artery calcium score as a predictor for incident stroke: systematic review and meta-analysis","volume":"236","author":"Chaikriangkrai","year":"2017","journal-title":"Int. J. Cardiol."},{"key":"10.1016\/j.ijcard.2019.06.003_bb0035","doi-asserted-by":"crossref","first-page":"2126","DOI":"10.1001\/jama.2016.17020","article-title":"Prevalence and prognostic implications of coronary artery calcification in low-risk women: a meta-analysis","volume":"316","author":"Kavousi","year":"2016","journal-title":"JAMA"},{"key":"10.1016\/j.ijcard.2019.06.003_bb0040","article-title":"Coronary artery calcium score prediction of all cause mortality and cardiovascular events in people with type 2 diabetes: systematic review and meta-analysis","volume":"346","author":"Kramer","year":"2013","journal-title":"BMJ (Online)"},{"key":"10.1016\/j.ijcard.2019.06.003_bb0045","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1001\/archinte.164.12.1285","article-title":"Using the coronary artery calcium score to predict coronary heart disease events: a systematic review and meta-analysis","volume":"164","author":"Pletcher","year":"2004","journal-title":"Arch. Intern. Med."},{"key":"10.1016\/j.ijcard.2019.06.003_bb0050","doi-asserted-by":"crossref","first-page":"2008","DOI":"10.1001\/jama.283.15.2008","article-title":"Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group","volume":"283","author":"Stroup","year":"2000","journal-title":"JAMA"},{"key":"10.1016\/j.ijcard.2019.06.003_bb0055","doi-asserted-by":"crossref","first-page":"427","DOI":"10.7326\/0003-4819-144-6-200603210-00010","article-title":"Evaluation of the quality of prognosis studies in systematic reviews","volume":"144","author":"Hayden","year":"2006","journal-title":"Ann. Intern. Med."},{"key":"10.1016\/j.ijcard.2019.06.003_bb0060","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/j.atherosclerosis.2013.12.029","article-title":"Incremental prognostic value of coronary artery calcium score versus CT angiography among symptomatic patients without known coronary artery disease","volume":"233","author":"Hulten","year":"2014","journal-title":"Atherosclerosis"},{"key":"10.1016\/j.ijcard.2019.06.003_bb0065","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1161\/CIRCIMAGING.110.955351","article-title":"Prognostic value of coronary computed tomographic angiography in comparison with calcium scoring and clinical risk scores","volume":"4","author":"Hadamitzky","year":"2011","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"10.1016\/j.ijcard.2019.06.003_bb0070","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1093\/ehjci\/jet148","article-title":"Does coronary CT angiography improve risk stratification over coronary calcium scoring in symptomatic patients with suspected coronary artery disease? Results from the prospective multicenter international CONFIRM registry","volume":"15","author":"Al-Mallah","year":"2014","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"10.1016\/j.ijcard.2019.06.003_bb0075","doi-asserted-by":"crossref","first-page":"2433","DOI":"10.1055\/s-2005-918586","article-title":"Prediction of serious cardiovascular events by determining coronary artery calcification measured by multi-slice computed tomography","volume":"130","author":"Becker","year":"2005","journal-title":"Dtsch. Med. Wochenschr."},{"key":"10.1016\/j.ijcard.2019.06.003_bb0080","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1007\/s12471-016-0819-5","article-title":"Independent prognostic value of coronary artery calcium score and coronary computed tomography angiography in an outpatient cohort of low to intermediate risk chest pain patients","volume":"24","author":"Bom","year":"2016","journal-title":"Neth. Hear. J."},{"key":"10.1016\/j.ijcard.2019.06.003_bb0085","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1016\/j.amjcard.2014.12.032","article-title":"Additive prognostic value of coronary artery calcium score over coronary computed tomographic angiography stenosis assessment in symptomatic patients without known coronary artery disease","volume":"115","author":"Chaikriangkrai","year":"2015","journal-title":"Am. J. Cardiol."},{"key":"10.1016\/j.ijcard.2019.06.003_bb0090","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1148\/radiol.11110744","article-title":"Stable angina pectoris: head-to-head comparison of prognostic value of cardiac CT and exercise testing","volume":"261","author":"Dedic","year":"2011","journal-title":"Radiology"},{"key":"10.1016\/j.ijcard.2019.06.003_bb0095","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCIMAGING.115.003966","article-title":"Prognostic value of coronary artery calcium scoring in addition to single-photon emission computed tomographic myocardial perfusion imaging in symptomatic patients","volume":"9","author":"Engbers","year":"2016","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"10.1016\/j.ijcard.2019.06.003_bb0100","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1016\/j.jcmg.2012.06.006","article-title":"Prognostic value of coronary CT angiography and calcium score for major adverse cardiac events in outpatients","volume":"5","author":"Hou","year":"2012","journal-title":"JACC Cardiovasc. Imaging"},{"key":"10.1016\/j.ijcard.2019.06.003_bb0105","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1016\/j.atherosclerosis.2014.01.038","article-title":"Prognostic value of coronary artery calcium and epicardial adipose tissue assessed by non-contrast cardiac computed tomography","volume":"233","author":"Kunita","year":"2014","journal-title":"Atherosclerosis"},{"key":"10.1016\/j.ijcard.2019.06.003_bb0110","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1148\/radiol.10100886","article-title":"Coronary artery calcium scoring does not add prognostic value to standard 64-section CT angiography protocol in low-risk patients suspected of having coronary artery disease","volume":"259","author":"Kwon","year":"2011","journal-title":"Radiology"},{"key":"10.1016\/j.ijcard.2019.06.003_bb0115","article-title":"The incremental prognostic value of cardiac computed tomography in comparison with single-photon emission computed tomography in patients with suspected coronary artery disease","volume":"11","author":"Lee","year":"2016","journal-title":"PLoS One"},{"key":"10.1016\/j.ijcard.2019.06.003_bb0120","article-title":"Significance of coronary calcification for prediction of coronary artery disease and cardiac events based on 64-slice coronary computed tomography angiography","volume":"2013","author":"Liu","year":"2013","journal-title":"Biomed. Res. Int."},{"key":"10.1016\/j.ijcard.2019.06.003_bb0125","doi-asserted-by":"crossref","first-page":"2098","DOI":"10.1016\/j.jacc.2013.02.029","article-title":"Prognostic interplay of coronary artery calcification and underlying vascular dysfunction in patients with suspected coronary artery disease","volume":"61","author":"Naya","year":"2013","journal-title":"J. Am. Coll. Cardiol."},{"key":"10.1016\/j.ijcard.2019.06.003_bb0130","series-title":"Prognostic Value of Coronary Artery Calcium Score in Patients with Symptoms Suggestive of Coronary Artery Disease. Results from the Silesian Calcium Score (SILICAS) \u2026. Polskie Archiwum \u2026","author":"Parma","year":"2016"},{"key":"10.1016\/j.ijcard.2019.06.003_bb0135","doi-asserted-by":"crossref","first-page":"1693","DOI":"10.1161\/CIRCULATIONAHA.107.717512","article-title":"Interrelation of coronary calcification, myocardial ischemia, and outcomes in patients with intermediate likelihood of coronary artery disease: a combined positron emission tomography\/computed tomography study","volume":"117","author":"Schenker","year":"2008","journal-title":"Circulation"},{"key":"10.1016\/j.ijcard.2019.06.003_bb0140","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1007\/s00392-004-0120-2","article-title":"Prognostic value of electron-beam computed tomography-derived coronary calcium scores compared with clinical parameters in patients evaluated for coronary artery disease - prognostic value of EBCT in symptomatic patients","volume":"93","author":"Schmermund","year":"2004","journal-title":"Zeitschrift Fur Kardiologie"},{"key":"10.1016\/j.ijcard.2019.06.003_bb0145","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/0735-1097(95)00460-2","article-title":"Prognostic value of coronary calcification and angiographic stenoses in patients undergoing coronary angiography","volume":"27","author":"Detrano","year":"1996","journal-title":"J. Am. Coll. Cardiol."},{"key":"10.1016\/j.ijcard.2019.06.003_bb0150","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1161\/hc2901.093112","article-title":"Long-term prognostic value of coronary calcification detected by electron-beam computed tomography in patients undergoing coronary angiography","volume":"104","author":"Keelan","year":"2001","journal-title":"Circulation"},{"key":"10.1016\/j.ijcard.2019.06.003_bb0155","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1016\/j.jcmg.2008.12.031","article-title":"Diagnostic and prognostic value of absence of coronary artery calcification","volume":"2","author":"Sarwar","year":"2009","journal-title":"JACC Cardiovasc. Imaging"},{"key":"10.1016\/j.ijcard.2019.06.003_bb0160","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/j.amjcard.2007.03.037","article-title":"Comparison of prognostic usefulness of coronary artery calcium in men versus women (results from a meta- and pooled analysis estimating all-cause mortality and coronary heart disease death or myocardial infarction)","volume":"100","author":"Bellasi","year":"2007","journal-title":"Am. J. Cardiol."},{"key":"10.1016\/j.ijcard.2019.06.003_bb0165","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1016\/j.annemergmed.2016.07.020","article-title":"Prognostic value of coronary artery calcium score in acute chest pain patients without known coronary artery disease: systematic review and meta-analysis","volume":"68","author":"Chaikriangkrai","year":"2016","journal-title":"Ann. Emerg. Med."},{"key":"10.1016\/j.ijcard.2019.06.003_bb0170","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.jcct.2017.02.010","article-title":"Clinical indications for coronary artery calcium scoring in asymptomatic patients: expert consensus statement from the Society of Cardiovascular Computed Tomography","volume":"11","author":"Hecht","year":"2017","journal-title":"J. Cardiovasc. Comput. Tomogr."},{"key":"10.1016\/j.ijcard.2019.06.003_bb0175","doi-asserted-by":"crossref","first-page":"1610","DOI":"10.1001\/jama.2010.461","article-title":"Coronary artery calcium score and risk classification for coronary heart disease prediction","volume":"303","author":"Polonsky","year":"2010","journal-title":"JAMA"},{"key":"10.1016\/j.ijcard.2019.06.003_bb0180","doi-asserted-by":"crossref","first-page":"1657","DOI":"10.1016\/j.jacc.2015.07.066","article-title":"Implications of coronary artery calcium testing among statin candidates according to American College of Cardiology\/American Heart Association Cholesterol Management Guidelines: MESA (multi-ethnic study of atherosclerosis)","volume":"66","author":"Nasir","year":"2015","journal-title":"J. Am. Coll. Cardiol."},{"key":"10.1016\/j.ijcard.2019.06.003_bb0185","doi-asserted-by":"crossref","first-page":"1268","DOI":"10.1016\/j.jacc.2009.07.017","article-title":"Selective use of coronary artery calcium screening: worth the cost?","volume":"54","author":"Blumenthal","year":"2009","journal-title":"J. Am. Coll. Cardiol."},{"key":"10.1016\/j.ijcard.2019.06.003_bb0190","doi-asserted-by":"crossref","first-page":"1258","DOI":"10.1016\/j.jacc.2009.07.018","article-title":"Induced cardiovascular procedural costs and resource consumption patterns after coronary artery calcium screening: results from the EISNER (early identification of subclinical atherosclerosis by noninvasive imaging research) study","volume":"54","author":"Shaw","year":"2009","journal-title":"J. Am. Coll. Cardiol."},{"key":"10.1016\/j.ijcard.2019.06.003_bb0195","doi-asserted-by":"crossref","first-page":"1622","DOI":"10.1016\/j.jacc.2011.01.019","article-title":"Impact of coronary artery calcium scanning on coronary risk factors and downstream testing: the EISNER (early identification of subclinical atherosclerosis by noninvasive imaging research) prospective randomized trial","volume":"57","author":"Rozanski","year":"2011","journal-title":"J. Am. Coll. Cardiol."},{"key":"10.1016\/j.ijcard.2019.06.003_bb0200","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/j.atherosclerosis.2005.06.018","article-title":"Visualizing coronary calcium is associated with improvements in adherence to statin therapy","volume":"185","author":"Kalia","year":"2006","journal-title":"Atherosclerosis"},{"key":"10.1016\/j.ijcard.2019.06.003_bb0205","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.1016\/j.jacc.2007.11.069","article-title":"Community-based provision of statin and aspirin after the detection of coronary artery calcium within a community-based screening cohort","volume":"51","author":"Taylor","year":"2008","journal-title":"J. Am. Coll. Cardiol."},{"key":"10.1016\/j.ijcard.2019.06.003_bb0210","doi-asserted-by":"crossref","first-page":"1860","DOI":"10.1016\/j.jacc.2006.10.079","article-title":"Long-term prognosis associated with coronary calcification: observations from a registry of 25,253 patients","volume":"49","author":"Budoff","year":"2007","journal-title":"J. Am. Coll. Cardiol."},{"key":"10.1016\/j.ijcard.2019.06.003_bb0215","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.atherosclerosis.2014.12.040","article-title":"Scoring of coronary artery calcium scans: history, assumptions, current limitations, and future directions","volume":"239","author":"Alluri","year":"2015","journal-title":"Atherosclerosis"},{"issue":"21","key":"10.1016\/j.ijcard.2019.06.003_bb0220","doi-asserted-by":"crossref","first-page":"1993","DOI":"10.1161\/CIRCULATIONAHA.117.030578","article-title":"The prognostic value of coronary artery calcium in the PROMISE study","volume":"136","author":"Budoff","year":"2017","journal-title":"Circulation"},{"key":"10.1016\/j.ijcard.2019.06.003_bb0225","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1001\/jama.2012.9624","article-title":"Comparison of novel risk markers for improvement in cardiovascular risk assessment in intermediate-risk individuals","volume":"308","author":"Yeboah","year":"2012","journal-title":"JAMA"},{"key":"10.1016\/j.ijcard.2019.06.003_bb0235","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1007\/s12471-011-0097-1","article-title":"Diagnostic and prognostic value of absence of coronary artery calcification in patients with stable chest symptoms","volume":"19","author":"Rijlaarsdam-Hermsen","year":"2011","journal-title":"Neth. Hear. J."},{"key":"10.1016\/j.ijcard.2019.06.003_bb0240","doi-asserted-by":"crossref","first-page":"2533","DOI":"10.1016\/j.jacc.2011.10.851","volume":"58","author":"Villines","year":"2011","journal-title":"J. Am. Coll. Cardiol."},{"key":"10.1016\/j.ijcard.2019.06.003_bb0245","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1148\/radiol.13122529","article-title":"Coronary artery calcium scoring to exclude flow-limiting coronary artery disease in symptomatic stable patients at low or intermediate risk","volume":"269","author":"Mouden","year":"2013","journal-title":"Radiology"},{"key":"10.1016\/j.ijcard.2019.06.003_bb0250","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/j.annemergmed.2010.01.017","article-title":"Coronary artery calcium scoring in the emergency department: identifying which patients with chest pain can be safely discharged home","volume":"56","author":"Nabi","year":"2010","journal-title":"Ann. Emerg. Med."},{"key":"10.1016\/j.ijcard.2019.06.003_bb0260","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1093\/ehjci\/jes060","article-title":"Meaning of zero coronary calcium score in symptomatic patients referred for coronary computed tomographic angiography","volume":"13","author":"Kim","year":"2012","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"10.1016\/j.ijcard.2019.06.003_bb0265","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1016\/j.jcmg.2008.11.015","article-title":"Prognostic value of coronary computed tomographic angiography for prediction of cardiac events in patients with suspected coronary artery disease","volume":"2","author":"Hadamitzky","year":"2009","journal-title":"JACC Cardiovasc. Imaging"}],"container-title":["International Journal of Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0167527318369250?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0167527318369250?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,9,28]],"date-time":"2025-09-28T20:46:29Z","timestamp":1759092389000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0167527318369250"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":51,"alternative-id":["S0167527318369250"],"URL":"https:\/\/doi.org\/10.1016\/j.ijcard.2019.06.003","relation":{},"ISSN":["0167-5273"],"issn-type":[{"value":"0167-5273","type":"print"}],"subject":[],"published":{"date-parts":[[2020,1]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Prognostic value of coronary artery calcium score in symptomatic individuals: A meta-analysis of 34,000 subjects","name":"articletitle","label":"Article Title"},{"value":"International Journal of Cardiology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ijcard.2019.06.003","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2019 Published by Elsevier B.V.","name":"copyright","label":"Copyright"}]}}