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Articles by Ron Blankstein
Predictive Utility of Coronary Artery Calcium Score Added to the PREVENT Atherosclerotic Cardiovascular Disease Equations
Key Points Question What is the change in model performance when adding coronary artery calcium (CAC) scores to predicted 10-year risk of atherosclerotic cardiovascular disease (ASCVD) with the Predicting Risk of Cardiovascular Disease EVENTS (PREVENT) ASCVD equations?
Predictive Utility of Coronary Artery Calcium Score Added to the PREVENT Atherosclerotic Cardiovascular Disease Equations
Supplement 1. eTable 1. Model Discrimination for Prediction of Incident Atherosclerotic Cardiovascular Disease, Stratified by Sex and by Race and Ethnicity eTable 2. Net Reclassification Improvement for Cardiovascular Disease Risk Categories Using PREVENT-ASCVD UACR Add-On Equations, Stratified by ASCVD Event Status eTable 3. Net Reclassification Improvement for Cardiovascular Disease Risk Categories Using PREVENT-ASCVD Base Equations, Stratified by Sex eTable 4.
Photon-Counting CT Plaque Analysis Consistent With Energy-Integrating Detector CT
Energy-integrating detector (EID) computed tomography (CT) and photon-counting detector CT (PCD-CT) are highly consistent in AI-enabled plaque quantification, stenosis grade, and FFRCT values, according to recent research.1 CT has long been clinical routine based on rapid technical progress – the introduction of PCD-CT is the current pinnacle of this innovation. Existing cardiac CT is plagued by limited spatial resolution and a lack of quality spectral data.
AI-CPA Plaque Assessment Results Consistent, Reproducible Among Observers
Inter-observer and intra-observer results of AI-informed coronary computed tomography angiography (CCTA) derived coronary plaque volume quantification (AI-CPA) are consistent with limited variation, indicating potential reproducibility, according to a recent study.1 Presented at the 21st Annual Scientific Meeting of the Society for Cardiovascular Computed Tomography (SCCT) in San Diego, California, by Biyanka Jaltotage, MD, a cardiologist at Fiona Stanley Hospital, the present study sought to...
Total Plaque Volume Indicates Patients With 0 CAC May Still be at Risk
Despite presenting with a coronary artery calcium (CAC) score of 0, symptomatic patients can remain at significant risk from non-calcified plaque that cannot be detected with standard calcium scoring, according to a recent substudy of the DECIDE registry.1 This analysis was presented at the 21st Annual Scientific Meeting of the Society of Cardiovascular Computed Tomography (SCCT) in San Diego, California, by Ron Blankstein, MD, the associate director of the cardiovascular imaging program,...
Guiding Preventive Care Strategies for Patients With Atherosclerotic Plaque on Coronary CTA: Primary Outcomes of the DECIDE Registry
JACC Journals › JACC: Cardiovascular Imaging › Archives › Vol.
In Defense of the 2026 Dyslipidemia Guideline
Re: Lipid Guidelines: Four Major Concerns To the Editor: We wanted to respond to Dr John Mandrola’s critique of the 2026 ACC/AHA/Multisociety Dyslipidemia Guideline, which was endorsed by 11 medical societies.[1] There is indeed overwhelming evidence supporting our practice-changing Guideline. Dr Mandrola wrote that there is discordance between evidence and class of recommendation.
2025 ACC/AHA/ASE/ASNC/SCCT/SCMR Advanced Training Statement on Advanced Cardiovascular Imaging: A Report of the ACC Competency Management Committee
JACC Journals › JACC › Archives › Vol. 87 No. 5 Advanced Training Statement : JACC Volume 87, Number 5 ACC Competency Management Committee Gaby Weissman, MD, FACC, Chair Mahi L. Ashwath, MD, MBA, FACC John P. Breinholt III, MD, FACC‡‡‡‡ Daniel E. Clark, MD, MPH, FACC Julie B. Damp, MD, FACC Jennifer Day, MSN, RN‡‡‡‡ Ali Denktas, MD, FACC‡‡‡‡ David Drajpuch, ACNP-BC, CRNP, FNP-BC, MSN‡‡‡‡ Nadeen Faza, MD Lowell Frank, MD Martin E. Goldman, MD, FACC Rebecca T. Hahn, MD, FACC‡‡‡‡ Susan D.
Guiding Automated Implementation Strategies for Patients With Atherosclerotic Plaque on Coronary Computed Tomographic Angiography: Rationale and Design of the Artificial Intelligence-DECIDE Study | JACC: Cardiovascular Imaging
JACC Journals › JACC: Imaging › Archives › Vol. 18 No. 10 Original Research : JACC: Cardiovascular Imaging Volume 18, Number 10 The diagnostic evaluation for patients at risk for coronary artery disease (CAD) usually includes referral to noninvasive testing to assess stress-induced ischemia or identify the extent and severity of CAD.
Quantitative Coronary Plaque Analysis in Clinical Practice: 2025 ACC Scientific Statement: A Report of the American College of Cardiology
Introduction The American College of Cardiology (ACC) has a long history of developing documents to complement clinical practice guidelines. Among these documents, scientific statements represent a novel approach to inform clinicians about areas where the scientific evidence is new and evolving or where data are more limited.
Racial and Ethnic Differences in Long-Term Cardiovascular Mortality Among Women and Men From the CAC Consortium:
References 1. "Coronary calcium as a predictor of coronary events in four racial or ethnic groups". N Engl J Med . 2008;358:1336-1345. https://doi.org/10.1056/NEJMoa072100. 2. "Rationale and design of the coronary artery calcium consortium: a multicenter cohort study". J Cardiovasc Comput Tomogr . 2017;11:54-61. https://doi.org/10.1016/j.jcct.2016.11.004. 3. "Sex differences in calcified plaque and long-term cardiovascular mortality: observations from the CAC Consortium". Eur Heart J . 2018;39:3727-3735.
Sex Differences in the Association Between Lipoprotein(a) and Cardiovascular Outcomes: The MGB Lp(a) Registry
Research Article Open Access Nonstandard Abbreviations and Acronyms MGB Mass General Brigham RPDR Research Patient Data Registry Clinical Perspective • In patients with no prior atherosclerotic cardiovascular disease within the MGB (Mass General Brigham) Lp(a) Registry, elevated lipoprotein(a) was associated with higher rates of cardiovascular outcomes, particularly myocardial infarction, in both women and men.
Transforming the Cardiovascular Disease Prevention Paradigm
Transforming the Cardiovascular Disease Prevention Paradigm: See Disease, Treat Disease Effects of Combining Coronary Calcium Score With Treatment on Plaque Progression in Familial Coronary Artery Disease Nitesh Nerlekar, MBBS, MPH, PhD; Sheran A. Vasanthakumar, MBBS; Kristyn Whitmore, BSN; Cheng Hwee Soh, PhD; Jasmine Chan, MBBS; Vinay Goel, MBBS; Jacqueline Ryan, MN, NP; Catherine Jones, MBBS; Tony Stanton, MBChB, PhD; Geoffrey Mitchell, MBBS, PhD; Andrew Tonkin, MD; Gerald F.
Cover Image, Volume 35, Issue 9
Jeffrey R. Winterfield and Usha B. Tedrow are cosenior authors. Disclosure: Dr. John was supported by the Pierce Family Fellowship. Dr. Divakaran was supported by a Khoury Innovation Award from the Brigham and Women's Hospital Heart and Vascular Center. Dr. Tedrow reports consulting fees with Biosense Webster and Thermedical Inc and serves on an advisory board for Biosense Webster.
Septal late enhancement by cardiac CT is associated with repeat ablation in nonischemic cardiomyopathy patients
REFERENCES 1, , , et al. Outcomes in catheter ablation of ventricular tachycardia in dilated nonischemic cardiomyopathy compared with ischemic cardiomyopathy: results from the Prospective Heart Centre of Leipzig VT (HELP-VT) study. Circulation. 2014; 129: 728-736. 2, , , , , . Contrast-enhanced MRI-derived scar patterns and associated ventricular tachycardias in nonischemic cardiomyopathy: implications for the ablation strategy. Circ Arrhythm Electrophysiol. 2013; 6: 875-883. 3, , , et al.
RACIAL AND ETHNIC DIFFERENCES IN LONG-TERM CARDIOVASCULAR MORTALITY AMONG WOMEN AND MEN FROM THE CAC CONSORTIUM
The authors have declared no competing interest. None I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: All sites and database analysis are overseen by continuing IRB review and approval.
Systemic Inflammation With High-Sensitivity C-Reactive Protein and Atherosclerotic Plaque Progression:
References 1. "The heart in COVID-19: Primary target or secondary bystander?"J Am Coll Cardiol Basic Trans Science . 2020;5:5: 537-542. 2. "Acute myocardial infarction after laboratory-confirmed influenza infection". N Engl J Med . 2018;378:4: 345-353. 3. "Role of acute infection in triggering acute coronary syndromes". Lancet Infect Dis . 2010;10:2: 83-92. 4. "Effects of statins on coronary atherosclerotic plaques: the PARADIGM study". J Am Coll Cardiol Img . 2018;11:10: 1475-1484. 5.
Advances in Coronary Computed Tomographic Angiographic Imaging of Atherosclerosis for Risk Stratification and Preventive Care:
References 1. "Noninvasive assessment of plaque morphology and composition in culprit and stable lesions in acute coronary syndrome and stable lesions in stable angina by multidetector computed tomography". J Am Coll Cardiol . 2006;47:1655-1662. 2. "Quantitative assessment of atherosclerotic plaque, recent progress and current limitations". J Cardiovasc Comput Tomogr . 2022;16:124-137. 3. "Artificial intelligence in cardiovascular CT: current status and future implications". J Cardiovasc Comput Tomogr .
Reporting and Outcomes of Coronary Calcification on Lung Cancer Screening CT
To evaluate the accuracy and downstream testing and statin prescribing of real-world reporting of coronary calcification on lung cancer screening (LCS) CT. We retrospectively reviewed LCS CTs from January 2015 to November 2021 for reporting of coronary calcification; reports that denoted coronary calcification as a significant incidental finding (“S” modifier) were also noted.
Why heart attacks are rising for young people, according to experts
Yet even before that infamous game against the Cincinnati Bengals, experts had been raising alarms about the COVID-19 pandemic, which is demonstrably linked to heart disease.More recently a national survey by The Ohio State University Wexner Medical Center revealed that young people remain largely unconcerned about their risk of heart disease even though experts continue to warn about the disturbing trends." As it turns out, the growing epidemic of youth heart disease precedes the Hamlin...
‘We know more about disease than health,’ but advances in CV imaging may change that
Source/Disclosures Disclosures: Wann and Fuster report no relevant financial disclosures. Blankstein reports consulting for/receiving honoraria from Caristo, Novartis and Silence Therapeutics and receiving grant/research support from Amgen. Douglas reports receiving institutional research grants from HeartFlow, in-kind research support from Caption Health and Kowa and honoraria from UpToDate/Kluwer. We were unable to process your request. Please try again later.
Implications of the 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Chest Pain Guideline for Cardiovascular Imaging: A Multisociety Viewpoint
JACC Journals › JACC: Imaging › Archives › Vol. 15 No. 5 Introduction The 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Chest Pain Guideline has many important implications for the field of cardiovascular imaging. Although this guideline offers a thoughtful consensus document created by various societies representing different stakeholders, it also has important implications for the practice patterns of each individual modality.
Hybrid Cardiac Magnetic Resonance/Fluorodeoxyglucose Positron Emission Tomography to Differentiate Active From Chronic Cardiac Sarcoidosis:
Abstract Objectives The purpose of this study was to investigate the diagnostic value of simultaneous hybrid cardiac magnetic resonance (CMR) and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) for detection and differentiation of active (aCS) from chronic (cCS) cardiac sarcoidosis. Background Late gadolinium enhancement (LGE) CMR and FDG-PET are both established imaging techniques for the detection of CS.
Coronary artery disease in East and South Asians: differences observed on cardiac CT
Coronary artery disease in East and South Asians: differences observed on cardiac CT http://orcid.org/0000-0001-8479-1943Alexander Chua1, Daniel Adams1, Damini Dey2, http://orcid.org/0000-0002-8393-6562Ron Blankstein3, Timothy Fairbairn4, Jonathon Leipsic5, Abdul Rahman Ihdayhid1, Brian Ko1 1 MonashHEART, Monash Health and Monash University, Clayton, Victoria, Australia 2 Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA 3 Department of Medicine,...
Addressing Imaging Pitfalls to Reduce Cardiovascular Disease Misdiagnosis in Patients With Breast Cancer Following Reconstruction
Women treated for breast cancer are electing to undergo implant-based reconstruction at increasing rates.
The 2021 Chest Pain Guideline: A Revolutionary New Paradigm for Cardiac Testing
JACC Journals › JACC: Imaging › Archives › Vol. 15 No. 1 Introduction The 2021 American Heart Association/American College of Cardiology/American Society of Echocardiography/CHEST/Society for Academic Emergency Medicine/Society of Cardiovascular Computed Tomography/Society for Cardiovascular Magnetic Resonance Guideline for the Evaluation and Diagnosis of Chest Pain has now been published (1).
A Policy Statement on Cardiovascular Test Substitution and Authorization: Principles of Patient-Centered Noninvasive Testing
JACC Journals › JACC › Archives › Vol. 78 No. 13 Cardiovascular Medicine and Society Consensus Principles • Optimal patient care should be the priority for physicians and insurance providers. • Given equivalent diagnostic accuracy and appropriate use criteria, there is no clear justification for routinely and indiscriminately recommending one diagnostic strategy over another. • Test substitution driven by short-term cost savings should not be endorsed.
Coronary artery disease in East and South Asians: differences observed on cardiac CT
Coronary artery disease in East and South Asians: differences observed on cardiac CT http://orcid.org/0000-0001-8479-1943Alexander Chua1, Daniel Adams1, Damini Dey2, http://orcid.org/0000-0002-8393-6562Ron Blankstein3, Timothy Fairbairn4, Jonathon Leipsic5, Abdul Rahman Ihdayhid1, Brian Ko1 1MonashHEART, Monash Health and Monash University, Clayton, Victoria, Australia 2Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA 3Department of Medicine,...
Becoming an Expert Practitioner: The Lifelong Journey of Education in Cardiovascular Imaging∗
Introduction Writer Malcolm Gladwell in his book Outliers popularized the concept that there are no instant experts but rather that masters of their domain spend a minimum of 10,000 h before gaining expertise in complex tasks (1). In medical training, it has been estimated that, if trainees devoted 5 h a day, 6 days a week to learning activities, it would require approximately 7 years to reach the 10,000-h threshold (2).
New Insights on COVID-19 and the Heart:
Introduction Cardiac imaging has played an important role in understanding the presence and extent of cardiac involvement in coronavirus disease-2019 (COVID-19) (1,2), as well as identifying patients who have a worse prognosis (3,4). Although the amount of scientific data that have emerged on this topic in <1 year has been astonishing, understanding the generalizability and clinical implications of the various reported studies has been challenging.
Society of Cardiovascular Computed Tomography / North American Society of Cardiovascular Imaging - Expert Consensus Document on Coronary CT Imaging of Atherosclerotic Plaque - Journal of Cardiovascular Computed Tomography
Abstract Coronary computed tomographic angiography (CCTA) provides a wealth of clinically meaningful information beyond anatomic stenosis alone, including the presence or absence of nonobstructive atherosclerosis and high-risk plaque features as precursors for incident coronary events. There is, however, no uniform agreement on how to identify and quantify these features or their use in evidence-based clinical decision-making.
What is multimodality cardiovascular imaging and how can it be delivered?
What is multimodality cardiovascular imaging and how can it be delivered?
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)
Abstract Background: The American College of Cardiology (ACC)/American Heart Association (AHA) cholesterol management guidelines have significantly broadened the scope of candidates eligible for statin therapy. Objectives: This study evaluated the implications of the absence of coronary artery calcium (CAC) in reclassifying patients from a risk stratum in which statins are recommended to one in which they are not.
The growing role of coronary CTA in stable CAD
November 11, 2020 7 min read Save Source/Disclosures ADD TOPIC TO EMAIL ALERTS Receive an email when new articles are posted on Please provide your email address to receive an email when new articles are posted on . We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com. With advances across multiple imaging modalities, decision-making regarding the optimal test for the evaluation of CAD can be challenging.
The growing role of coronary CTA in stable CAD
November 11, 2020 7 min read Save Source/Disclosures ADD TOPIC TO EMAIL ALERTS Receive an email when new articles are posted on Please provide your email address to receive an email when new articles are posted on . We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com. With advances across multiple imaging modalities, decision-making regarding the optimal test for the evaluation of CAD can be challenging.
What is Multimodality Cardiovascular Imaging and How Can It Be Delivered?
What is Multimodality Cardiovascular Imaging and How Can It Be Delivered?
Warranty Period of a Calcium Score of Zero: Comprehensive Analysis From the Multiethnic Study of Atherosclerosis
Abstract Objectives This study sought to quantify and model conversion of a normal coronary artery calcium (CAC) scan to an abnormal CAC scan. Background Although the absence of CAC is associated with excellent prognosis, progression to CAC >0 confers increased risk. The time interval for repeated scanning remains poorly defined.
What is Multimodality Cardiovascular Imaging and How Can It Be Delivered?
What is Multimodality Cardiovascular Imaging and How Can It Be Delivered? Statistics from Altmetric.com Request Permissions If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways. Copyright information: © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions.
Current Evidence and Recommendations for Coronary CTA First in Evaluation of Stable Coronary Artery Disease
Journal of the American College of Cardiology Cardiovascular Medicine and Society Michael Poon, John R. Lesser, Cathleen Biga, Ron Blankstein, Christopher M. Kramer, James K. Min, Pamela S. Noack, Christina Farrow, Udo Hoffman, Jaime Murillo, Koen Nieman and Leslee J. Shaw This article requires a subscription or purchase to view the full text. If you are a subscriber or member, click the login link or the subscribe link in the top menu above to access this article.
Smoking cessation after MI lowers mortality risk in young adults
August 11, 2020 2 min read Save Source/Disclosures ADD TOPIC TO EMAIL ALERTS Receive an email when new articles are posted on Please provide your email address to receive an email when new articles are posted on . We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com. Young adults who quit smoking within 1 year after an MI reduced their risk for all-cause and CV mortality by more than 50%, researchers found.
Cholesterol Guidelines
Journal of the American College of Cardiology Editorial Comment Ron Blankstein and Avinainder Singh This article requires a subscription or purchase to view the full text. If you are a subscriber or member, click the login link or the subscribe link in the top menu above to access this article. Author + information This article requires a subscription or purchase to view the full text. If you are a subscriber or member, click Login or the Subscribe link (top menu above) to access this article.
COVID-19 pandemic may play critical role in increased CTA use
July 24, 2020 5 min read Save Source/Disclosures Source: Blankstein R. Leipsic J. Cardiac CT in the COVID Pandemic. Both presented at: Society of Cardiovascular Computed Tomography Annual Scientific Meeting; July 17-18, 2020 (virtual meeting). Disclosures: Blankstein reports no relevant financial disclosures.
Barriers prevent wider adoption of cardiac CT
July 22, 2020 3 min read Save Source/Disclosures Source: Blankstein R. Cardiovascular CT in 2020: Current Developments, Guidelines and Trials. Presented at: Society of Cardiovascular Computed Tomography Annual Scientific Meeting; July 17-18, 2020 (virtual meeting). Disclosures: Blankstein reports no relevant financial disclosures. ADD TOPIC TO EMAIL ALERTS Receive an email when new articles are posted on Please provide your email address to receive an email when new articles are posted on .
Multimodality Cardiovascular Imaging in the Midst of the COVID-19 Pandemic: Ramping up Safely to a New Normal
JACC: Cardiovascular Imaging Debates in Imaging William A. Zoghbi, Marcelo F. DiCarli, Ron Blankstein, Andrew D. Choi, Vasken Dilsizian, Frank A. Flachskampf, Jeffrey B. Geske, Paul A. Grayburn, Farouc A. Jaffer, Raymond Y. Kwong, Jonathan A. Leipsic, Thomas H. Marwick, Eike Nagel, Koen Nieman, Subha V. Raman, Michael Salerno, Partho P. Sengupta, Leslee J. Shaw, Y.S. Chandrashekhar and developed in collaboration with the ACC Imaging Council Author + information
Incidence of New Coronary Calcification
Journal of the American College of Cardiology Letters Omar Dzaye, Zeina A. Dardari, Miguel Cainzos-Achirica, Ron Blankstein, Moyses Szklo, Matthew J. Budoff, Joao A.C. Lima, Roger S. Blumenthal, Khurram Nasir and Michael J. Blaha This article requires a subscription or purchase to view the full text. If you are a subscriber or member, click the login link or the subscribe link in the top menu above to access this article.
Extensive Coronary Artery Calcifications
JACC: Cardiovascular Imaging Editor's Page Ron Blankstein and Y. Chandrashekhar Author + information Ron Blankstein, MDa and Y. Chandrashekhar, MDb,∗ (shekh003{at}umn.ed) aBrigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts bUniversity of Minnesota School of Medicine and Veterans Affairs Medical Center, Minneapolis, Minnesota ↵∗Address for correspondence: Dr. Y.
Screening for atherosclerosis among low risk individuals with family history of coronary heart disease
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Controversies in Diagnostic Imaging of Patients With Suspected Stable and Acute Chest Pain Syndromes
JACC: Cardiovascular Imaging Debates in Imaging Leslee J. Shaw, Ron Blankstein, David L. Brown, Sanket S. Dhruva, Pamela S. Douglas, Tessa S.S. Genders, Raymond J. Gibbons, John P. Greenwood, Raymond Kwong, Jonathon Leipsic, John J. Mahmarian, David Maron, Eike Nagel, Ed Nicol, Koen Nieman, Patricia A. Pellikka, Rita F. Redberg, Jonathan Weir-McCall, Michelle C. Williams and Y. Chandrasekhar This article requires a subscription or purchase to view the full text.
YOUNG-MI: 1 in 5 early heart attack survivors under age 40
NEW ORLEANS — In the YOUNG-MI registry, which compared outcomes of young and very young MI survivors, roughly 20% of individuals with a first MI are aged 40 years or younger.
Outcomes in Stable Coronary Disease
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