{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T12:24:26Z","timestamp":1777983866452,"version":"3.51.4"},"reference-count":47,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2024,8,11]],"date-time":"2024-08-11T00:00:00Z","timestamp":1723334400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Scleroderma and Related Disorders"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Coronary artery calcification assessed on thoracic computed tomography represents the calcific component of established coronary artery disease, is a biomarker of total atheromatous plaque burden and predicts mortality. Systemic sclerosis is a pro-inflammatory condition, and inflammation is also a driver of coronary artery disease. We assessed coronary artery calcification prevalence, mortality risk and potential clinical impact on primary prevention in a cohort of patients with systemic sclerosis, differentiated by clinical phenotype including the presence of interstitial lung disease and pulmonary arterial hypertension.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Retrospective analysis of 258 computed tomographies in systemic sclerosis patients from three prospectively maintained clinical and research databases at a single tertiary rheumatology\/pulmonary hypertension (PH) service between March 2007 and September 2020 (mean age\u2009=\u200965\u2009\u00b1\u200912, 14% male). Co-morbidities, statin prescription and all-cause mortality were recorded. Patients were subtyped according to underlying systemic sclerosis complications. Computed tomographies were re-reviewed for coronary artery calcification; severity was graded using a 4-point scale per vessel and summed for total coronary artery calcification score. The impact of reporting coronary artery calcification was assessed against pre-existing statin prescriptions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Coronary artery calcification was present in 58% (149\/258). Coronary artery calcification was more prevalent in systemic sclerosis-pulmonary arterial hypertension than in systemic sclerosis subgroups with interstitial lung disease or without pulmonary arterial hypertension, controlling for age, sex, co-morbidities and smoking status (71%; \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      (13)\u2009=\u200981.4; p\u2009&lt;\u20090.001). The presence and severity of coronary artery calcification were associated with increased risk of mortality independently of age and co-morbidities (hazard ratio\u2009=\u20092.8; 95% confidence interval\u2009=\u20091.2\u20136.6; p\u2009=\u20090.018). The \u2018number needed to report\u2019 coronary artery calcification presence to potentially impact management was 3.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Coronary artery calcification is common in systemic sclerosis. Coronary artery calcification predicts mortality independently of age and confounding co-morbidities which suggests this finding has clinical relevance and is a potential target for screening and therapeutic intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23971983241264090","type":"journal-article","created":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T01:32:06Z","timestamp":1723426326000},"page":"192-202","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Coronary artery calcification is prevalent in systemic sclerosis and is associated with adverse prognosis"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1097-7897","authenticated-orcid":false,"given":"Jennifer","family":"Rossdale","sequence":"first","affiliation":[{"name":"Respiratory Department, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK"},{"name":"Department of Life Sciences, University of Bath, Bath, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Graby","sequence":"additional","affiliation":[{"name":"Cardiology Department, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK"},{"name":"Department for Health, University of Bath, Bath, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maredudd","family":"Harris","sequence":"additional","affiliation":[{"name":"Radiology Department, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Calum","family":"Jones","sequence":"additional","affiliation":[{"name":"Radiology Department, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davyd","family":"Greenish","sequence":"additional","affiliation":[{"name":"Radiology Department, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Bartlett","sequence":"additional","affiliation":[{"name":"Radiology Department, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Gilroy","sequence":"additional","affiliation":[{"name":"Radiology Department, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamie","family":"Sanghera","sequence":"additional","affiliation":[{"name":"Respiratory Department, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2793-2364","authenticated-orcid":false,"given":"John D","family":"Pauling","sequence":"additional","affiliation":[{"name":"Royal National Hospital for Rheumatic Diseases, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK"},{"name":"Rheumatology Department, North Bristol NHS Trust, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Skeoch","sequence":"additional","affiliation":[{"name":"Royal National Hospital for Rheumatic Diseases, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria","family":"Flower","sequence":"additional","affiliation":[{"name":"Department of Life Sciences, University of Bath, Bath, UK"},{"name":"Royal National Hospital for Rheumatic Diseases, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rob","family":"Mackenzie Ross","sequence":"additional","affiliation":[{"name":"Respiratory Department, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jay","family":"Suntharalingam","sequence":"additional","affiliation":[{"name":"Respiratory Department, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK"},{"name":"Department of Life Sciences, University of Bath, Bath, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan CL","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Department for Health, University of Bath, Bath, UK"},{"name":"Radiology Department, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,8,11]]},"reference":[{"key":"bibr1-23971983241264090","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra043430"},{"key":"bibr2-23971983241264090","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2017.10.012"},{"key":"bibr3-23971983241264090","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2016.07.020"},{"key":"bibr4-23971983241264090","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.08.035"},{"key":"bibr5-23971983241264090","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.10.066"},{"key":"bibr6-23971983241264090","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2019.08.023"},{"key":"bibr7-23971983241264090","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2012-203151"},{"key":"bibr8-23971983241264090","doi-asserted-by":"publisher","DOI":"10.1097\/RTI.0000000000000553"},{"key":"bibr9-23971983241264090","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2023.02.007"},{"key":"bibr10-23971983241264090","doi-asserted-by":"publisher","DOI":"10.21037\/tlcr.2018.05.05"},{"key":"bibr11-23971983241264090","unstructured":"Reporting 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