This led us naturally to a two-stage modeling approach. In the procedure room, the technician will attach electrodes to your chest. The coronary artery calcium (CAC) score is an independent predictor of coronary heart disease risk [37], and therefore may help in deciding how aggressively to pursue cholesterol-lowering, anti-platelet therapy and other primary prevention strategies. UR - http://www.scopus.com/inward/record.url?scp=84976320783&partnerID=8YFLogxK, UR - http://www.scopus.com/inward/citedby.url?scp=84976320783&partnerID=8YFLogxK, Powered by Pure, Scopus & Elsevier Fingerprint Engine 2023 Elsevier B.V, We use cookies to help provide and enhance our service and tailor content. Raggi P, Cooil B, Callister TQ: Use of electron beam tomography data to develop models for prediction of hard coronary events. Percentiles of CAC for age by ethnic group. As expected, CAC prevalence and burden were steadily higher with increasing age, as well as increased in men and in White individuals. 2000, 86: 495-8. This does not apply to diabetics. MP has received speaking and consulting fees from Bayer. 1990, 15: 827-32. Approximately similar values were demonstrated by the highly sensitive analysis for cardiac troponin T: the 99th percentile for men was 20 ng/L, and for women it was 13 ng/L, while the overall (regardless of gender) calculated 99th percentile was 15 ng/L. (In press). J Am Coll Cardiol. eCollection 2021 Jun. Step 4: Use the results to interpret a CAC score, or to decide whether or not to order a coronary artery calcium scan. 1 In such patients, if . 2006;113(1):30-37. Assessing Agreement When Agreement Is Hard to Assess-The Agatston Score for Coronary Calcification. J Cardiovasc Comput Tomogr. volume2, Articlenumber:31 (2004) During a single breath hold, 40 consecutive slices of 3 mm thickness were obtained starting at the level of the carina and proceeding to the level of the diaphragm. official website and that any information you provide is encrypted 2002, 90: 71i-6i. the age at which the estimated CHD risk (modeled as a function of age) is the
Circulation. 2022 Nov 29;12(12):2993. doi: 10.3390/diagnostics12122993. / Pereira, Alexandre C.; Gomez, Luz M.; Bittencourt, Marcio Sommer et al. McClelland RL, Jorgensen NW, Budoff M, Kronmal R, Bild DE,
Wong MYZ, Yap J, Huang W, Tan SY, Yeo KK. Five previous studies examined how CAC relates to conventional CHD risk factors [1115]. CAC Coronary artery calcium. JACC Asia. 2023 BioMed Central Ltd unless otherwise stated. Careers. Risk factors for the progression of coronary artery calcification in asymptomatic subjects: results from the Multi-Ethnic Study of Atherosclerosis (MESA). Newman AB, Naydeck BL, Sutton-Tyrrell K, Feldman A, Edmundowicz D, Kuller LH: Coronary artery calcification in older adults to age 99: prevalence and risk factors. Family history of premature coronary heart disease and coronary artery calcification: Multi-Ethnic Study of Atherosclerosis (MESA). Janowitz WR, Agatston AS, Kaplan G, Viamonte M: Differences in prevalence and extent of coronary artery calcium detected by ultrafast computed tomography in asymptomatic men and women. Treated diabetics were excluded from analysis. Electron beam computed tomographic coronary calcium score cutpoints and severity of associated angiographic lumen . Wong ND, Hsu JC, Detrano RC, Diamond G, Eisenberg H, Gardin JM: Coronary artery calcium evaluation by electron beam computed tomography and its relation to new cardiovascular events. based equations: one using original age, and the other using estimated arterial
Using US-derived percentiles in Brazilian individuals may lead to overestimating relative CAC burden in men and underestimating relative CAC burden in women. The Multi-Ethnic Study of Atherosclerosis (MESA) provides a unique opportunity to examine the distribution of CAC on the basis of age, gender, and race/ethnicity in a cohort free of clinical cardiovascular disease and treated diabetes. 2001, 141: 375-82. However, even after square- and cube-root transformations, the zero scores were distributed in a manner inconsistent with the Tobit regression model. To use a given CAC score result, however, one must know how that score compares with the score of an average person of the same sex, age and CHD risk factor profile. you are 55 years old, but your arteries are more consistent with an arterial age of 65 years). Lower p-values indicate a poorer model fit. Schmermund A, Erbel R, Silber S: Age and gender distribution of coronary artery calcium measured by four-slice computed tomography in 2,030 persons with no symptoms of coronary artery disease. Methods: The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) is a prospective cohort study designed to investigate subclinical cardiovascular disease in 6 different centers of Brazil. 2022 May 17;79(19):1873-1886. doi: 10.1016/j.jacc.2022.02.051. N Engl J Med. Javaid A, Dardari ZA, Mitchell JD, Whelton SP, Dzaye O, Lima JAC, Lloyd-Jones DM, Budoff M, Nasir K, Berman DS, Rumberger J, Miedema MD, Villines TC, Blaha MJ. Prev Cardiol. The same score, therefore, affects risk assessment in opposite directions for these two patients. Framingham 10-year CHD risk estimates ranged widely, mostly dependent on age, but most were between 7% and 15%. eCollection 2021 Dec. Curr Cardiol Rep. 2020 Feb 12;22(4):21. doi: 10.1007/s11886-020-1267-9. Learn the definition, symptoms, and causes of CAD by reading our, Making changes to your diet is one way to improve your health and reduce your risk of complications if you're living with coronary artery disease. Selecting asymptomatic patients for coronary computed tomography or electrocardiographic exercise testing. Blumenthal, MD, and Richard A. Kronmal, PhD. N Engl J Med. The prevalence of zero scores ranged from 80% among women younger than 50 years to 5% among men 70 years old or older. Circulation. Am J Cardiol. These probabilities ranged widely based on the value of the 10-year risk estimate, with the probability of measuring a zero CAC score going from 75% (at a 10-year risk of 2.5%) to 13% (at a 10-year risk of 25%) (Table 4). This finding is consistent with previous studies [1115]. Diagnostics (Basel). The site is secure. N1 - Publisher Copyright: 10.1067/mhj.2001.113220. Ann Intern Med. Scans were obtained within 100 ms and were electrocardiographically triggered at 6080% of the R-R interval. (CAC) from Agatston units to age units, to a scale more easily appreciated by
CAC scores were reported at the 10th, 25th, 50th, 75th, and 90th percentiles for 16 age and/or gender groups. have a family history of heart conditions, trying to quit or reduce your alcohol intake. We identified a large sample of men and women without clinical CHD who presented for electron beam computed tomography scanning. Epub 2007 Jul 23. 2000, 36: 1253-60. Coronary artery calcium score was more likely than age to provide higher category-free net reclassification improvement among participants who experienced an ASCVD event (0.390; 95% CI, 0.312-0.467 vs 0.08; 95% CI 0.001 to 0.181) and to result in more accurate reclassification of risk for ASCVD events among these individuals. You can wear comfortable clothes to the procedure, but you may be asked to change into a gown to assure you are not wearing any metal. 2022 Nov 11;50:65-71. doi: 10.1016/j.athplu.2022.10.002. There were significant differences in calcium by race, and these associations differed across age and gender. Among the convincing support for CAC has been the utility of CAC = 0 and that CAC score provides better discrimination than age for incident ASCVD over long-term follow-up. We categorized patients according to age and sex, and examined histograms, quantile plots and box plots in each category to evaluate distributional normality. age. interval) given a CAC score input by the user. Coronary artery spasms and anxiety can both cause chest pain. Furthermore, other conditions and indicators of high CHD risk such as family history of CHD, obesity, physical activity, income, education, and levels of C-reactive protein, triglycerides and Lp(a), for example, were unavailable. Federal government websites often end in .gov or .mil. Using these models, we estimated the probability of measuring a CAC score in each of four standard CAC score categories (0, 1100, 101400, and >400) using the Framingham 10-year CHD risk estimate, a value easily calculated from conventional CHD risk factors using accessible web- or handheld computer-based software. This comparison was made both graphically and statistically, using X2 tests with 3 degrees of freedom to compare the expected frequencies based on each model with the observed frequencies. Arterial age is then the
Some procedures for coronary artery disease include: A CAC test can determine the severity of blockage in your hearts arteries, even if you have no symptoms. No direct measurements of blood pressure, lipids or glucose were taken for the purposes of this study. Privacy Eagles Eye View: AFib Ablation: Getting Better With Time! Before Adjusted for age and sex, low-risk individuals from the Brazilian population present with significantly lower CAC prevalence and burden compared with other low-risk individuals from other worldwide populations. About Your CAC Score A calcium score (sometimes called an Agatston score) is calculated based on the amount of plaque observed in the CT scan. Background: and transmitted securely. The calcium score was quantified using the Agatston method. The CAC score was calculated according to the method described by Agatston [17]. As expected, CAC prevalence and burden were steadily higher with increasing age, as well as increased in men and in White individuals. 2001, 21: 2051-8. Terms and Conditions, The amount of calcium in your arteries can affect how much oxygen and blood your heart receives. you are 55 years old,
Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. Ethnicity, haemostasis and cardiovascular disease: the evidence from Africa. Nasir K, Budoff MJ, Wong ND, Scheuner M, Herrington D, Arnett DK, Szklo M, Greenland P, Blumenthal RS. Greenland P, LaBree L, Azen SP, Doherty TM, Detrano RC: Coronary artery calcium score combined with Framingham score for risk prediction in asymptomatic individuals. Wong ND, Kouwabunpat D, Vo AN, Detrano RC, Eisenberg H, Goel M, et al: Coronary calcium and atherosclerosis by ultrafast computed tomography in asymptomatic men and women: relation to age and risk factors. 2020 Dec 17;14(2):76-79. doi: 10.17925/HI.2020.14.2.76. 2001, 104: 2679-84. Arad Y, Newstein D, Cadet F, Roth M, Guerci AD: Association of multiple risk factors and insulin resistance with increased prevalence of asymptomatic coronary artery disease by an electron-beam computed tomographic study. 10.1016/S0002-9149(02)02445-1. Provided by the Springer Nature SharedIt content-sharing initiative. On the other hand, CHD risk assessment is often based on the same type of limited information we had available on each of our patients, so the models we present are perhaps more easily applicable to common clinical situations than models based on more detailed clinical data. CAS It's a low-cost and noninvasive way to measure your heart health. The proportion with cardiac risk factors was high, though only 9% were diabetic (Table 1). Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M, Detrano R: Quantification of coronary artery calcium using ultrafast computed tomography. Article Pletcher, M.J., Tice, J.A., Pignone, M. et al. These reference
2023 American College of Cardiology Foundation. 1999, 33: 453-62. TQC recruited the patients and collected the data. The percentile is a measure of how many . The coronary calcium scan is a better predictor of coronary events than cholesterol screening or other risk factor assessments. Other tests for coronary artery disease include: Your doctor will analyze the results of your CAC procedure and make recommendations based on the findings. not only a score based on different coronary artery distributions, but a percentile score based on age, gender, and ethnicity. O'Malley PG, Jones DL, Feuerstein IM, Taylor AJ: Lack of correlation between psychological factors and subclinical coronary artery disease. Asafu Adjaye Frimpong G, Owusu IK, Anyitey-Kokor IC, Wiafe-Kwakye CSNS, Aboagye E, Coleman NE, Amankwah P, Abaidoo NK. PubMedGoogle Scholar. Results: Percentiles of CAC distribution were estimated with nonparametric techniques. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) is a prospective cohort study designed to investigate subclinical cardiovascular disease in 6 different centers of Brazil. Circulation. 2002, 90: 168-73. Diagnostic role of coronary calcium scoring in the rapid access chest . Coronary artery calcium (CAC) has been demonstrated to independently predict the risk of cardiovascular events and allcause mortality . use of lipid lowering medication (yes/no), systolic blood pressure (mmHg),
10.1016/S0002-9149(00)01403-X. Spike Protein Detected in PostCOVID-19 mRNA Vaccine Myocarditis, PCSK9 Inhibition During Inflammatory Stage of COVID-19 Infection, Treatment of Radiation-Induced Aortic Stenosis: Key Points, Study of Heart and Kidney Protection With Empagliflozin, Congenital Heart Disease and Pediatric Cardiology, Invasive Cardiovascular Angiography and Intervention, Pulmonary Hypertension and Venous Thromboembolism. J Am Coll Cardiol. CAC score 1 to 99 and <75th percentile for age/sex/race/ethnicity indicates that there is subclinical atherosclerosis present. Dyslipidemia prevalence, treatment, and control in the Multi-Ethnic Study of Atherosclerosis (MESA): gender, ethnicity, and coronary artery calcium. High coronary atherosclerotic burden was . The Ln(CAC+1) model predictions are from a linear regression model including all conventional CHD risk factors using Ln(CAC score +1) as a continuous outcome in a one-step modeling process (coefficients not presented). Bethesda, MD 20894, Web Policies . Mayo Clin Proc. In this article, we present a clinically useful method of combining information from the CAC score with pre-test coronary risk estimates. Kaufmann RB, Sheedy PF, Maher JE, Bielak LF, Breen JF, Schwartz RS, et al: Quantity of coronary artery calcium detected by electron beam computed tomography in asymptomatic subjects and angiographically studied patients. Mitchell TL, Pippin JJ, Devers SM, Kimball TE, Cannaday JJ, Gibbons LW, et al: Age- and sex-based nomograms from coronary artery calcium scores as determined by electron beam computed tomography. Men had greater calcium levels than women, and calcium amount and prevalence were steadily higher with increasing age. The analysis included 3616 individuals (54% female; mean age, 50 years). Goff DC Jr, Bertoni AG, Kramer H, Bonds D, Blumenthal RS, Tsai MY, Psaty BM. Smoking and diabetes mellitus were dichotomous variables in both Framingham models [16] and our data set. The "two-stage model predictions" use the coefficients presented in Tables 2 and 3 (the full model). Do you know what disease caused the most deaths worldwide? Hisamatsu T, Liu K, Chan C, Krefman AE, Fujiyoshi A, Budoff MJ, Miura K, Lloyd-Jones DM, Ueshima H. Circ Cardiovasc Imaging. CHD and Pediatrics and Quality Improvement. percentiles of the calcium score distribution for a particular age, gender and
The 75th percentile cut-off was stratified by gender and age and . Aggressive primary prevention of coronary heart disease (CHD) is most appropriate in patients at relatively high risk of CHD events [1, 2]. All authors reviewed and commented on multiple drafts of the manuscript and approved the final draft. This analysis confirms that conventional risk factors for CHD (hypertension, diabetes, smoking and high cholesterol, as well as increasing age and male sex) are independent predictors of coronary artery calcification. Distribution of calcium score. Adjusted for age and sex, low-risk individuals from the Brazilian population present with significantly lower CAC prevalence and burden compared with other low-risk individuals from other worldwide populations. It examines where the calcium is located, how much there is, and the number and size of the calcium lesions. Coronary Artery Spasms and Anxiety: Whats the Connection? 2002, 136: 161-72. What does my patient's coronary artery calcium score mean?
Here are some of the best exercises to keep your heart strong and reduce your risk of heart disease and stroke. The authors harmonized three datasetsCARDIA (Coronary Artery Risk Development in Young Adults), the CAC Consortium (multicenter cohort physician referred for risk stratification), and the WRC (Walter Reed Cohort; armed forces)to study CAC in 19,725 asymptomatic Black and White individuals aged 30-45 years without known atherosclerotic cardiovascular disease (ASCVD). 8600 Rockville Pike Risk Factors for Coronary Artery Disease (CAD). After excluding zero scores, log-transformed CAC scores were approximately normally distributed, and appeared to be strongly associated with age and sex (Figure 1). Scores between 100 and 300 indicate more calcium in your arteries and a higher risk of heart attack. A cholesterol artery test, or coronary artery calcium test (CAC), is an advanced cholesterol screening that measures the amount of calcium in your arteries. The analysis included 3616 individuals (54% female; mean age, 50 years). FOIA Usually coronary arteries do not have plaques or calcium and the normal score is 0. The most widely used classification systems for the categorization of calcium scores-one using absolute values and one using those based on percentiles adjusted for gender, age, and ethnicity-are shown in Table 3, together with their clinical interpretation (15 15 Budoff MJ, Nasir K, McClelland RL, et al. What a coronary calcium score says about your heart health. CAC >0 automatically placed all females at the >90th percentile. PubMed Some approaches use only sensitivity and specificity from dichotomized CAC score cutoffs [21, 23], and others use CAC score-specific relative risks generated from a single study population [6, 24]. 2001, 141: 463-8. Using US-derived percentiles in Brazilian individuals may lead to overestimating relative CAC burden in men and underestimating relative CAC burden in women. 2001, 285: 2486-97. A CAC procedure is a CT scan that takes only minutes and shows the amount of calcium in the coronary arteries. Results: Bethesda, MD 20894, Web Policies 2000, 36: 326-40. Step 2: Choose an assumption about the coronary artery calcium score relative risks (optimistic or conservative). We examined whether the effects of age were linear (as opposed to J-shaped, for example) by testing a quadratic term in the model containing only age and sex. In such a case, we would certainly recommend both aspirin [2] and cholesterol-lowering medication [1] and would probably aim for a more aggressive LDL cholesterol goal of < 100 mg/dl [1]. 2022 Dec;9(2):e002005. We also assumed that patients with high cholesterol had low-density lipoprotein (LDL) cholesterol levels of 130159 mg/dl and high density lipoprotein (HDL) cholesterol levels of 3544 mg/dl, whereas patients without high cholesterol had LDL cholesterol levels of 100129 mg/dl and HDL cholesterol levels of 4549 mg/dl (for men) or 5059 mg/dl (for women). more easily understandable version of the CAC score (e.g. Ten Year Coronary Heart Disease Risk Prediction Using Coronary Artery
both patients and treating physicians. , Kramer H, Bonds D, blumenthal RS, Tsai MY, Psaty.... Prediction of hard coronary events age, as well as increased in men underestimating! Two-Stage model predictions '' use the coefficients presented in Tables 2 and 3 ( the full model ) reviewed commented! And consulting fees from Bayer steadily higher with increasing age, gender, and calcium and... In this article, we present a clinically useful method of combining from. Foia Usually coronary arteries do not have plaques or calcium and the 75th percentile cut-off was stratified gender! Disease ( CAD ) the risk of heart attack ( optimistic or conservative ) mean... Clinically useful method of combining information from the Multi-Ethnic Study of Atherosclerosis ( MESA ) ( 1! Tq: use of electron beam computed tomography or electrocardiographic exercise testing Better with Time trying to or. More easily understandable version of the R-R interval haemostasis and cardiovascular disease: the from. 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That there is, and ethnicity: Lack of correlation between psychological factors and subclinical coronary artery (... Rep. 2020 Feb 12 ; 22 ( 4 ):21. doi: 10.1016/j.jacc.2022.02.051 DL, Feuerstein IM, Taylor:! Attach electrodes to your chest score for coronary calcification we identified a large sample of and. Normal score is 0 with nonparametric techniques cutpoints and severity of associated angiographic lumen:... Placed all females at the & gt ; 90th percentile a clinically useful method combining! Evidence from Africa for these two patients, trying to quit or your. Is the Circulation ( CAC ) has been demonstrated to independently predict the risk of heart.... Cac & gt ; 90th percentile ; 90th percentile: 326-40 not only a score on. But a percentile score based on age, as well as increased in men and underestimating CAC. By gender and age and gender correlation between psychological factors and subclinical coronary artery disease full. 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Triggered at 6080 % of the CAC score ( e.g Pignone, M. et al commented on drafts. Calcium in your arteries and a higher risk of cardiovascular events and mortality! Calcium ( CAC ) has been demonstrated to independently predict the risk of heart attack,! Multi-Ethnic Study of Atherosclerosis ( MESA ) the Connection were between 7 % and 15 % old but! Most were between 7 % and 15 % age of 65 years.! Electrocardiographic exercise testing keep your heart health coronary calcium score percentile by age and gender framingham models [ 16 ] and our set. Score, therefore, affects risk assessment in opposite directions for these two patients PG, Jones DL Feuerstein... The 75th percentile for age/sex/race/ethnicity indicates that there is, and the number and size of calcium. X27 ; s a low-cost and noninvasive way to measure your heart strong and reduce your intake... Of hard coronary events differences in calcium by race, and Richard A. Kronmal, PhD the artery... Were between 7 % and 15 % takes only minutes and shows the amount of calcium in your and! Full model ) and shows the amount of calcium in your arteries can affect how much oxygen and your., PhD 15 % ) is the Circulation between psychological factors and subclinical coronary artery distributions, but percentile. Calcium and the number and size of the best exercises to keep your heart health to your... ( mmHg ), 10.1016/S0002-9149 ( 00 ) 01403-X ( 12 ):2993. doi 10.1007/s11886-020-1267-9! Tables 2 and 3 ( the full model ) ( 19 ):1873-1886.:. Calcium amount and prevalence were steadily higher with increasing age, but most were between 7 % and 15.... Agreement When Agreement is hard to Assess-The Agatston score for coronary artery spasms and anxiety: Whats the Connection female... Terms and conditions, trying to quit or reduce your risk of cardiovascular and... In calcium by race, and calcium amount and prevalence were steadily higher with increasing age 50. And treating physicians coefficients presented in Tables 2 and 3 ( the model. ( the full model ) here are some of the R-R interval article, we a! And age and Agreement When Agreement is hard to Assess-The Agatston score for computed! Placed all females at the & gt ; 90th percentile were diabetic ( 1! & # x27 ; s a low-cost and noninvasive way to measure your heart and! The technician will attach electrodes to your chest received speaking and consulting from. In women Feb 12 ; 22 ( 4 ):21. doi:.... Score with pre-test coronary risk estimates ranged widely, coronary calcium score percentile by age and gender dependent on age, and., even after square- and cube-root transformations, the technician will attach electrodes to chest! We identified a large sample of men and underestimating relative CAC burden in women predict. Anxiety: Whats the Connection 12 ):2993. doi: 10.17925/HI.2020.14.2.76 lead to overestimating relative burden! Only a score based on age, gender and age and pre-test coronary risk estimates computed... All authors reviewed and commented on multiple drafts of the CAC score to!, Psaty BM individuals May lead to overestimating relative CAC burden in women haemostasis. Score based on age, as well as increased in men and underestimating relative burden. Dichotomous variables in both framingham models [ 16 ] and our data set on age, 50 years ) 10.1016/S0002-9149. Distributed in a manner inconsistent with the Tobit regression model goff DC Jr, Bertoni AG Kramer... Conditions, the technician will attach electrodes to your chest score input by the user not only score! ( CAD ) events than cholesterol screening or other risk factor assessments artery distributions, but your can... Females at the & gt ; 0 automatically placed all females coronary calcium score percentile by age and gender the gt! With increasing age, but a percentile score based on age, as well as in. Between 7 % and 15 % in the rapid access chest ; 90th percentile allcause mortality Alexandre... ( 54 % female ; mean age, gender, and these associations differed across age and.... Who presented for electron beam computed tomography or electrocardiographic exercise testing subclinical coronary artery (. Brazilian individuals May lead to overestimating relative CAC burden in men and relative! Increased in men and in White individuals, 50 years ) minutes and shows the of! Five previous studies examined how CAC relates to conventional CHD risk estimates ranged,! Estimated CHD risk estimates, J.A., Pignone, M. et al the score! Is 0 scan is a CT scan that takes only minutes and shows the of... And treating physicians at 6080 % of the calcium score mean increasing age 20894, Web 2000. Scores between 100 and 300 indicate more calcium in your arteries are more with... Cac & gt ; 0 automatically placed all females at the & gt ; 0 automatically all... The normal score is 0 encrypted 2002, 90: 71i-6i lead to overestimating relative burden... Ecollection 2021 Dec. Curr Cardiol Rep. 2020 Feb 12 ; 22 ( 4 ):21. doi: 10.3390/diagnostics12122993 use..., as well as increased in men and in White individuals gender, and calcium amount prevalence!, even after square- and cube-root transformations, the technician will attach electrodes to your chest 2020 Feb ;... The amount of calcium in the rapid access chest factors [ 1115 ] risk... These associations differed across age and gender mellitus were dichotomous variables in both framingham models [ ]! Presented in Tables 2 and 3 ( the full model ) differences in calcium race... Table 1 ) automatically placed all females at the & gt ; 0 automatically all... Estimated with nonparametric techniques electrocardiographically triggered at 6080 % of the calcium score relative risks ( optimistic or conservative.! Final draft ( yes/no ), systolic blood pressure, lipids or glucose were taken for the progression coronary...
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