{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T11:08:52Z","timestamp":1789470532894,"version":"build-2803163510"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Imaging"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Current guidelines recommend coronary artery calcium (CAC) scoring for stratification of atherosclerotic cardiovascular disease risk only in patients with borderline to intermediate risk score by the pooled cohort equation with low-density lipoprotein-cholesterol (LDL-C) of 70 to 190 mg\/dL. It remains unknown if CAC or thoracic aorta calcification (TAC), detected on routine chest computed tomography, can provide further risk stratification in patients with LDL-C\u2265190 mg\/dL.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>From a multisite medical center, we retrospectively identified all patients from March 2005 to June 2021 age \u226540 years, without established atherosclerotic cardiovascular disease and LDL-C\u2265190 mg\/dL who had non-gated non-contrast chest computed tomography within 3 years of LDL-C measurement. Ordinal CAC and TAC scores were measured by visual inspection. Kaplan-Meier curves and multivariable Cox-regression models were built to ascertain the association of CAC and TAC scores with all-cause mortality.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>We included 811 patients with median age 59 (53\u201368) years, 262 (32.3%) were male, and LDL-C median level was 203 (194\u2013217) mg\/dL. Patients were followed for 6.2 (3.29\u20139.81) years, and 109 (13.4%) died. Overall, 376 (46.4%) of patients had CAC=0 and 226 (27.9%) had TAC=0. All-cause mortality increased with any CAC and moderate to severe TAC. In a multivariate model, patients with CAC had a significantly higher mortality compared with those without CAC: mild hazard ratio (HR), 1.71 (1.03\u20132.83), moderate HR, 2.12 (1.14\u20133.94), and severe HR, 3.49 (1.94\u20136.27). Patients with moderate TAC (HR, 2.34 [1.19\u20134.59]) and those with severe TAC (HR, 3.02 [1.36\u20136.74]) had higher mortality than those without TAC.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>In patients without history of atherosclerotic cardiovascular disease and LDL-C\u2265190 mg\/dL, the presence and severity of CAC and TAC are independently associated with all-cause mortality.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circimaging.122.014135","type":"journal-article","created":{"date-parts":[[2022,6,21]],"date-time":"2022-06-21T18:00:21Z","timestamp":1655834421000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["Visual Coronary and Aortic Calcium Scoring on Chest Computed Tomography Predict Mortality in Patients With Low-Density Lipoprotein-Cholesterol \u2265190 mg\/dL"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8983-4866","authenticated-orcid":true,"given":"Francesco","family":"Castagna","sequence":"first","affiliation":[{"name":"Cardiology Division, Montefiore Medical Center, Bronx, NY (F.C., J.M., J.A., E.L., P.N., P.I., A.S., L.Z., C.J.R., M.J.G., L.S.)."},{"name":"Albert Einstein College of Medicine\u201a Bronx, NY (F.C., A.S., L.Z., C.J.R., J.M.L., M.J.G., L.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8078-1753","authenticated-orcid":true,"given":"Jeremy","family":"Miles","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine\u201a Bronx, NY (F.C., A.S., L.Z., C.J.R., J.M.L., M.J.G., L.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Arce","sequence":"additional","affiliation":[{"name":"Cardiology Division, Montefiore Medical Center, Bronx, NY (F.C., J.M., J.A., E.L., P.N., P.I., A.S., L.Z., C.J.R., M.J.G., L.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ephraim","family":"Leiderman","sequence":"additional","affiliation":[{"name":"Cardiology Division, Montefiore Medical Center, Bronx, NY (F.C., J.M., J.A., E.L., P.N., P.I., A.S., L.Z., C.J.R., M.J.G., L.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Neshiwat","sequence":"additional","affiliation":[{"name":"Cardiology Division, Montefiore Medical Center, Bronx, NY (F.C., J.M., J.A., E.L., P.N., P.I., A.S., L.Z., C.J.R., M.J.G., L.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Ippolito","sequence":"additional","affiliation":[{"name":"Cardiology Division, Montefiore Medical Center, Bronx, NY (F.C., J.M., J.A., E.L., P.N., P.I., A.S., L.Z., C.J.R., M.J.G., L.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Friedmann","sequence":"additional","affiliation":[{"name":"Departments of Surgery and Cardiothoracic and Vascular Surgery, Albert Einstein College of Medicine\u201a Bronx, NY (P.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aldo","family":"Schenone","sequence":"additional","affiliation":[{"name":"Cardiology Division, Montefiore Medical Center, Bronx, NY (F.C., J.M., J.A., E.L., P.N., P.I., A.S., L.Z., C.J.R., M.J.G., L.S.)."},{"name":"Albert Einstein College of Medicine\u201a Bronx, NY (F.C., A.S., L.Z., C.J.R., J.M.L., M.J.G., L.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lili","family":"Zhang","sequence":"additional","affiliation":[{"name":"Cardiology Division, Montefiore Medical Center, Bronx, NY (F.C., J.M., J.A., E.L., P.N., P.I., A.S., L.Z., C.J.R., M.J.G., L.S.)."},{"name":"Albert Einstein College of Medicine\u201a Bronx, NY (F.C., A.S., L.Z., C.J.R., J.M.L., M.J.G., L.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos J.","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine\u201a Bronx, NY (F.C., A.S., L.Z., C.J.R., J.M.L., M.J.G., L.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Blaha","sequence":"additional","affiliation":[{"name":"Johns Hopkins Ciccarone Center for the Prevention of Heart Disease\u201a Baltimore, MD (M.J.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey M.","family":"Levsky","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine\u201a Bronx, NY (F.C., A.S., L.Z., C.J.R., J.M.L., M.J.G., L.S.)."},{"name":"Radiology Department, Montefiore Medical Center, Bronx, NY (J.M.L., M.J.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario 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