{"doi":"10.1016/j.jcmg.2022.06.007","title":"Discordance Between Coronary Artery Calcium Area and Density Predicts Long-Term Atherosclerotic Cardiovascular Disease Risk","abstract":"BACKGROUND: Coronary artery calcium (CAC) is commonly quantified as the product of 2 generally correlated measures: plaque area and calcium density. OBJECTIVES: The authors sought to determine whether discordance between calcium area and density has long-term prognostic importance in atherosclerotic cardiovascular disease (ASCVD) risk. METHODS: The authors studied 10,373 primary prevention participants from the CAC Consortium with CAC >0. Based on their median values, calcium area and mean calcium density were divided into 4 mutually exclusive concordant/discordant groups. Cox proportional hazards regression assessed the association of calcium area/density groups with ASCVD mortality over a median of 11.7 years, adjusting for traditional risk factors and the Agatston CAC score. RESULTS: higher) were significantly associated with high calcium density discordance, whereas diabetes (OR: 2.23 [95% CI: 1.85-3.19]) was most strongly associated with discordantly low calcium density. Compared to those with low calcium area/low calcium density, individuals with low calcium area/high calcium density had a 71% lower risk of ASCVD death (HR: 0.29 [95% CI: 0.09-0.95]). CONCLUSIONS: For a given CAC score, high calcium density relative to plaque area confers lower long-term ASCVD risk, likely serving as an imaging marker of biological resilience for lesion vulnerability. Additional research is needed to define a robust definition of calcium area/density discordance for routine clinical risk prediction.","journal":"JACC. Cardiovascular imaging","year":2022,"id":256575,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":19,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9387,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":857261,"name":"Marly van Assen","orcid":"0000-0003-4044-4426","position":1,"is_corresponding":false},{"id":515228,"name":"Carlo N. De Cecco","orcid":"0000-0002-2956-3101","position":2,"is_corresponding":false},{"id":284561,"name":"Zeina Dardari","orcid":"0000-0001-6026-3329","position":3,"is_corresponding":false},{"id":253731,"name":"Daniel S. Berman","orcid":"0000-0002-3793-9578","position":4,"is_corresponding":false},{"id":24934,"name":"Matthew J. Budoff","orcid":"0000-0002-9616-1946","position":5,"is_corresponding":false},{"id":276020,"name":"Michael D. Miedema","orcid":"0000-0003-0499-5810","position":6,"is_corresponding":false},{"id":74982,"name":"Khurram Nasir","orcid":"0000-0001-5376-2269","position":7,"is_corresponding":false},{"id":276022,"name":"Alan Rozanski","orcid":"0000-0002-7278-4890","position":8,"is_corresponding":false},{"id":276021,"name":"John A. Rumberger","orcid":"0000-0001-5018-2832","position":9,"is_corresponding":false},{"id":235805,"name":"Leslee J. Shaw","orcid":"0000-0003-1268-1491","position":10,"is_corresponding":false},{"id":307077,"name":"Laurence Sperling","orcid":"0000-0001-9417-6370","position":11,"is_corresponding":false},{"id":284560,"name":"Seamus P. Whelton","orcid":"0000-0001-5914-0735","position":12,"is_corresponding":false},{"id":236227,"name":"Martin Bødtker Mortensen","orcid":"0000-0003-2693-4154","position":13,"is_corresponding":false},{"id":71977,"name":"Michael J. Blaha","orcid":"0000-0001-5138-9683","position":14,"is_corresponding":false},{"id":236228,"name":"Omar Dzaye","orcid":"0000-0001-9483-3510","position":15,"is_corresponding":false},{"id":339079,"name":"Alexander C. Razavi","orcid":"0000-0002-3213-0876","position":0,"is_corresponding":true}],"reference_count":21,"raw_metadata":null,"created_at":"2026-07-19T00:25:25.728895Z","pmid":"35850937","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}