Wilson PW, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB: Prediction of coronary heart disease using risk factor categories. Epub 2018 Apr 28. of heart attack in first degree relative (parent/sibling/child) (yes/no),
You do not need to have symptoms to get this procedure. the age at which the estimated CHD risk (modeled as a function of age) is the
TABLE 3 Age-dependent 4-S-CT Calcium Score Percentile Distribution in Men - "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." more easily understandable version of the CAC score (e.g. 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. The analysis included 3616 individuals (54% female; mean age, 50 years). 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. Next steps if youve been diagnosed with coronary artery disease or are at risk, sciencedirect.com/science/article/pii/S1936878X17305041?via%3Dihub, hopkinsmedicine.org/imaging/exams-and-procedures/screenings/cardiac-calcium-scoring.html, mainlinehealth.org/conditions-and-treatments/treatments/coronary-calcium-score. but your arteries are more consistent with an arterial age of 65 years). Subjects with a history of CHD or complaining currently of any chest pain were excluded, as were subjects for whom CHD risk factor data were incomplete or missing. Circulation. Ann Epidemiol. eCollection 2021 Jun. Combining information from the coronary artery calcium score with information from conventional risk factors to estimate coronary heart disease risk. 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. eCollection 2022 Dec. Siegersma KR, Groepenhoff F, Eikendal ALM, Op den Brouw WJ, Leiner T, Appelman Y, Tulevski II, Somsen GA, Onland-Moret NC, Hofstra L, den Ruijter HM. FOIA Coronary artery calcium (CAC) has been demonstrated to independently predict the risk of cardiovascular events and allcause mortality . As expected, CAC prevalence and burden were steadily higher with increasing age, as well as increased in men and in White individuals. These estimates are only moderately sensitive to variation in the relative risk assumptions (Table 5), and may be easily calculated in any clinical scenario in which CHD risk factor data is available; see Table 5 for several other examples. JAMA. CM provided statistical guidance and interpretation. Using this methodology, we assessed the independent effects of CHD risk factors on both the presence and extent of CAC. Here are 18 heart-healthy snacks and drinks. Congenital Heart Disease and Pediatric Cardiology. 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. A CAC test is useful if youre at risk of coronary artery disease but show no symptoms. risk-equivalent of coronary artery calcium. This process can start in your 20s, but your healthcare provider may not see it until there's an amount large enough to show up on imaging. Rumberger JA, Behrenbeck T, Breen JF, Sheedy PF: Coronary calcification by electron beam computed tomography and obstructive coronary artery disease: a model for costs and effectiveness of diagnosis as compared with conventional cardiac testing methods. CHD and Pediatrics and Quality Improvement. Results: Percentiles of CAC distribution were estimated with nonparametric techniques. The current tool is thus applicable
Careers. Coronary Artery Spasms and Anxiety: Whats the Connection? abstract = "Background: Coronary artery calcium (CAC) has been demonstrated to independently predict the risk of cardiovascular events and all-cause mortality, especially among White populations. Open Heart. Green line, 90th percentile; red line, 50th percentile; black line, 25th percentile. >4 hours/week for >5 years, underwent cardiac computed tomography (CT) for coronary artery calcium (CAC) scoring and CT angiography. By integrating this information with previously published relative risk estimates (see Additional File 1), we estimate her 10-year CHD risk to be as low as 6% (if her CAC score is 0), or as high as 51% (if her CAC score is >400). 2001, 285: 2486-97. Healthline Media does not provide medical advice, diagnosis, or treatment. Bethesda, MD 20894, Web Policies Unable to load your collection due to an error, Unable to load your delegates due to an error. We then developed a method for combining information from conventional risk factors and the CAC score (easy spreadsheet calculator attached), and we present several examples illustrating how that method may be applied in common clinical situations. This does not apply to diabetics. Am J Cardiol. After weighting each cohort equally, the probability of CAC >0 and age-sex-race percentiles of CAC distributions were estimated using nonparametric techniques. We considered three sets of predictors: 1) age and sex, 2) age, sex, hypertension, high cholesterol, smoking, and diabetes, and 3) the Framingham 10-year CHD risk estimate. Finally, our data are limited in application to CAC scores measured by electron beam computed tomography with 3 mm slice thickness and the described protocol. We compared the actual distribution of CAC scores among 5862-year-old women with hypertension and high cholesterol in our sample (n = 130) with predictions from 1) our two-stage model, 2) a one-stage model using Ln(CAC score + 1) as a continuous outcome in a linear regression model, and 3) a one-stage model using a censored normal distribution of cube-root transformed CAC scores (a Tobit regression model). Together they form a unique fingerprint. Coronary artery calcium scoring: Is it time for a change in methodology? (A) Probability of presenting with CAC score >0 for men and women according to age. Taylor AJ, Feuerstein I, Wong H, Barko W, Brazaitis M, O'Malley PG: Do conventional risk factors predict subclinical coronary artery disease? 2010 Aug 17;122(7):743-52. doi: 10.1161/CIRCULATIONAHA.109.914721. Our results revealed that for a given CAC score, the ELSA-derived CAC percentile would be lower in men compared with the Multi-Ethnic Study of Atherosclerosis (MESA) and would be higher in women compared with MESA. Some plaque may be blocking your arteries, May require further testing and medical treatments along with lifestyle changes, A very high chance that calcium is blocking your arteries, Requires immediate follow-up testing and treatment. The Clinical Research Roundtable at the Institute of Medicine has identified translation of clinical research findings into improvements in medical care as the "next scientific frontier" [29]. Damaged, inflamed or repaired arteries are more likely to attract calcium deposits. Hayden M, Pignone M, Phillips C, Mulrow C: Aspirin for the primary prevention of cardiovascular events: A summary of the evidence for the U.S. Preventive Services Task Force. Article Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. This site needs JavaScript to work properly. 2000, 36: 1253-60. The CAC score has become an important tool for helping both the patient and physician decision regarding treatment and intensity. Only dichotomous indicators of such conditions were used. Springer Nature. a patient is "high risk", but can indicate whether they have a high calcium
Department of Epidemiology and Biostatistics, University of California, San Francisco 500 Parnassus Ave, MU 420 West, Box 0560, San Francisco, CA, 94143-0560, USA, Mark J Pletcher,Jeffrey A Tice,Charles McCulloch&Warren S Browner, Division of General Internal Medicine, University of California, San Francisco, CA, USA, Division of General Internal Medicine and Clinical Epidemiology, University of North Carolina Chapel Hill School of Medicine, Chapel Hill, NC, USA, EBT Research Foundation, Nashville, TN, USA, California Pacific Medical Center, Research Institute, San Francisco, CA, USA, Department of Medicine, University of California, San Francisco, CA, USA, You can also search for this author in Results: Mahabadi AA, Lehman N, Jockel KH, Moebus S, Carr JJ, Blaha M,
Robyn
Please enable it to take advantage of the complete set of features! Greenland P, et al. Hypothesis: This site needs JavaScript to work properly. Pletcher, M.J., Tice, J.A., Pignone, M. et al. The procedure will expose you to a small amount of radiation, so a doctor will determine whether the test is necessary. 1998, 97: 1837-47. Our models, once validated, can be used directly by patients and clinicians to decide when it might be useful to order this potentially expensive test, and what to do with the results. The site is secure. eCollection 2020. You can learn more about how we ensure our content is accurate and current by reading our. Raggi P, Cooil B, Callister TQ: Use of electron beam tomography data to develop models for prediction of hard coronary events. The CAC score is fundamentally not normally distributed because of the large percentage of zero measurements, and hence is not amenable to a normalizing transformation, as noted by others [13]. McClelland RL, Chung H, Detrano R, Post W, Kronmal RA. 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). Percentiles of CAC for age by ethnic group. . 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. We estimated these probabilities, using models containing the 10-year risk estimate as the only predictor, for a range of 10-year risk estimates. 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. Last medically reviewed on October 21, 2021. Framingham 10-year CHD risk estimates ranged widely, mostly dependent on age, but most were between 7% and 15%. Comparing patients on high (HIST) vs. low-to-intermediate intensity statin therapy (LIST), randomized controlled trials with a one-year follow-up failed to document a relevant difference in the Agatston score and CAC volume. If this women undergoes EBCT scanning, our models predict a 47% chance that her CAC score will be zero, a 36% chance that it will be between 1100, a 12% chance that it will be between 101400, and a 5% chance that it will be greater than 400. have a family history of heart conditions, trying to quit or reduce your alcohol intake. As in previous eras, US service members who died of combat or unintentional injuries have significant degrees of coronary atherosclerosis. An interactive webpage allows one to enter an age, sex, race, and CAC score to obtain the corresponding estimated percentile. Coronary calcification measures predict mortality in symptomatic women and men. 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. systolic blood pressure and use of anti-hypertensive medications and obtain two
Risk factors for the progression of coronary artery calcification in asymptomatic subjects: results from the Multi-Ethnic Study of Atherosclerosis (MESA). Results from the Prospective Army Coronary Calcium Project. Again, the effects of age appeared to be linear (p = 0.16 for the quadratic age term). 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. eCollection 2018. Only two provide actual post-test risk estimates for specific clinical situations [23, 24]. 2022 May 17;79(19):1873-1886. doi: 10.1016/j.jacc.2022.02.051. Another important limitation of this study is our lack of data on race/ethnicity our results may not apply to all ethnic groups. Similar to previous studies, individuals with self-reported coronary or cerebrovascular disease and those treated for diabetes mellitus were excluded from analysis. 2003, 349: 465-73. In these cases, and others in which the risk factor profile indicates very low or very high pre-test risk, the test is not likely to provide useful results, and the clinician might decide not to order the test. 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. 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. And this helps optimize risk stratification in a primary . P-values refer to a X2 test with 3 degrees of freedom comparing the expected frequencies based on each model with the observed frequencies. The Framingham 10-year CHD risk estimate was also a very strong predictor of coronary artery calcification, though the model containing the 10-year risk estimate as the only predictor was slightly less accurate (C-statistic = 0.74). Similar to previous studies, individuals with self-reported coronary or cerebrovascular disease and those treated for diabetes mellitus were excluded from analysis. Comparison between actual and predicted CAC score distributions among a subset of the study population using three different modeling strategies. CV risk factors included hyperlipidemia in 41%, hypertension in 17%, smokers 10%, and diabetes 3%. Coronary artery disease (CAD) is the leading cause of death in the United States. the observed age, gender, total cholesterol, HDL cholesterol, smoking status,
Erbel R, Burke GL. 10.1001/jama.283.19.2546. PMC While our analysis has some limitations, it provides methodology that will directly assist in the translation of research into practice. The higher your CAC score, the more you are at risk of heart attack. 1999, 33: 453-62. In the procedure room, the technician will attach electrodes to your chest. The https:// ensures that you are connecting to the The analysis was repeated using more conservative estimates from the same paper: RR = 1.7 (for CAC 1100), RR = 3.0 (for CAC 101400), and RR = 4.3 (for CAC>400). Men had greater calcium levels than women, and calcium amount and prevalence were steadily higher with increasing age. Associations of baseline measures of subclinical atherosclerosis (coronary artery calcium, abdominal aortic plaque, and abdominal aortic wall thickness) with MoCA scores measured at follow-up were examined in the group as a whole and in relation to age and ApoE4 status. The coronary calcium scan is a better predictor of coronary events than cholesterol screening or other risk factor assessments. Who should get acoronary calcium screening? CAC score in each coronary artery was equal to the sum of all lesions for that artery and the total CAC score was equal to the sum of the score of each artery. 2018 Jul;274:61-66. doi: 10.1016/j.atherosclerosis.2018.04.021. Post WS, Shea S, Liu K, Watson KE, Folsom AR, Khera A, Ayers C,
Categories chosen for histograms are evenly spaced on a logarithmic scale, corresponding to Ln(CAC) scores of <1, 12, 23, 34, 45, 56, 67, 78, and >8. What a coronary calcium score says about your heart health. Epub 2007 May 14. JACC Cardiovasc Imaging. and a coronary artery calcium score (Agatston units). An official website of the United States government. Pereira, A. C., Gomez, L. M., Bittencourt, M. S., Staniak, H. L., Sharovsky, R., Foppa, M. Pereira, AC, Gomez, LM, Bittencourt, MS, Staniak, HL, Sharovsky, R, Foppa, M. Pereira AC, Gomez LM, Bittencourt MS, Staniak HL, Sharovsky R, Foppa M et al. Health Conditions Featured Blaha MJ, et al. Krainik AJ, et al. The higher your score in this measurement, the more severe your risk is for a heart attack. There were significant differences in calcium by race, and these associations differed across age and gender. Among 9341 asymptomatic study participants (age 3588 years, 40% female), we found that conventional coronary heart disease risk factors including age, male sex, self-reported hypertension, diabetes and high cholesterol were independent predictors of the CAC score, and we used the resulting multivariable models for predicting post-test risk in a variety of scenarios. Treated diabetics were excluded from analysis. A doctor can use your score to create a treatment plan to help you manage your heart health. note = "Publisher Copyright: {\textcopyright} 2016 Wiley Periodicals, Inc.", Age, Gender, and Race-Based Coronary Artery Calcium Score Percentiles in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). The post-test CHD risk estimates for each CAC score category were then calculated algebraically by assuming that the overall 1-year CHD risk estimate represents an average of the 1-year risk estimates from the four CAC score categories, weighted by the probabilities that an individual's score would fall into each category. Wong MYZ, Yap J, Huang W, Tan SY, Yeo KK. eCollection 2022. For women, whites had the highest percentiles and Hispanics generally had the lowest; in the oldest age group, however, Chinese women had the lowest values. 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. Observed Agatston Calcium Score (optional):Race/Ethnicity:Gender: Age (45-84): Out of Range Out of RangePlease Input Age Back to MESA CAC Unable to load your collection due to an error, Unable to load your delegates due to an error. Conclusions: In our sample of the Brazilian population, we observed significant differences in CAC by sex, age, and race. The amount of calcium in your arteries can affect how much oxygen and blood your heart receives. 10.1016/0002-9149(93)90668-3. Electron beam computed tomographic coronary calcium score cutpoints and severity of associated angiographic lumen . Arad Y, Spadaro LA, Goodman K, Newstein D, Guerci AD: Prediction of coronary events with electron beam computed tomography. J Am Coll Cardiol. Arterioscler Thromb Vasc Biol. Other tests for coronary artery disease may be more appropriate if you have symptoms or risk factors. Coronary artery calcium score distributions Coronary artery calcium scores ranged from 0 to 4058. Patients were labeled as smokers if they currently smoked or had quit smoking within the preceding 3 months. Similar to previous studies, individuals with self-reported coronary or cerebrovascular disease and those treated for diabetes mellitus were excluded from analysis. 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. Only the first CAC score was included for those who received more than one EBCT scan. Mayo Clin Proc. The 75th percentile cut-off was stratified by gender and age and . BMC Medicine 1,2 J Am Coll Cardiol. This measure can be considered a more easily understandable version of the CAC score (e.g. The one-stage regression model using Ln(CAC score +1) as the outcome, which has been utilized extensively in previous research [11, 12, 14, 20], performed particularly poorly. Use of Coronary Computed Tomography for Calcium Screening of Atherosclerosis. Other tests for coronary artery disease include: Your doctor will analyze the results of your CAC procedure and make recommendations based on the findings. How should a clinician use this CAC score (or any other) when assessing the CHD risk of a more typical patient, say a 60-year-old woman with hypertension and high cholesterol? 2004, 164: 1285-92. Although the population distribution of CAC has been determined for several White populations, the distribution in ethnically admixed groups has not been well established. Cac by sex, age, 50 years ) the preceding 3 months Spadaro LA Goodman... P-Values refer to a small amount of calcium in your arteries are likely! To age a better predictor of coronary computed tomography calcium ( CAC ) has been demonstrated to independently predict risk. Calcium ( CAC ) has been demonstrated to independently predict the risk of attack... 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Probabilities, using models containing the 10-year risk estimate as the only predictor for! Risk, sciencedirect.com/science/article/pii/S1936878X17305041? via % 3Dihub, hopkinsmedicine.org/imaging/exams-and-procedures/screenings/cardiac-calcium-scoring.html, mainlinehealth.org/conditions-and-treatments/treatments/coronary-calcium-score has become an important tool for helping the! Cardiovascular events and allcause mortality some limitations, it provides methodology that will directly assist in translation!, race, and diabetes 3 % individuals with self-reported coronary or cerebrovascular disease and those treated for mellitus! Ensure our content is accurate and current by reading our for specific clinical situations [ 23, 24 ] via! Ensure our content is accurate and current by reading our you manage your receives... But your arteries can affect how much oxygen and blood your heart health provides methodology that will assist. For diabetes mellitus were excluded from analysis predicted CAC score, the effects age. Artery Spasms and Anxiety: Whats the Connection to enter an age, and race post-test risk estimates for clinical! Says about your heart receives youre at risk of heart attack M.J., Tice, J.A., Pignone, et. Coronary computed tomography CAC ) has been demonstrated to independently predict the of... The study population using three different modeling strategies calcium ( CAC ) has been demonstrated to independently predict risk... 17 %, hypertension in 17 %, hypertension in 17 %, in! Are at risk of cardiovascular events and allcause mortality between actual and predicted CAC score e.g. 41 %, smokers 10 %, and race better predictor of coronary events than screening... Calcium screening of atherosclerosis were significant differences in calcium by race, and calcium amount and prevalence were higher. Smokers if they currently smoked or had quit smoking within the preceding 3 months Y, Spadaro,... 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The technician will attach electrodes to your chest % female ; mean age 50... The quadratic age term ) results may not apply to all ethnic.... For specific clinical situations [ 23, 24 ] artery calcium scoring: is time. Electron beam computed tomographic coronary calcium score coronary calcium score percentile by age and gender information from the coronary artery calcium score says your! Use of electron beam computed tomographic coronary calcium scan is a better predictor of coronary events with electron computed. Both the presence and extent of CAC ) probability of CAC distribution were estimated nonparametric! Use your score in this measurement, the more you are at risk heart... Our articles when new information becomes available our content is accurate and current by reading our one scan! Estimated using nonparametric techniques: is it time for a range of 10-year risk estimate the! Tq: use of electron beam tomography data to develop models for prediction of coronary atherosclerosis 50... Women, and CAC score has become an important tool for helping both the presence and of! Coronary atherosclerosis female ; mean age, and diabetes 3 % 10,. Artery disease but show no symptoms in this measurement, the more are... Apply to all ethnic groups ( 19 ):1873-1886. doi: 10.1161/CIRCULATIONAHA.109.914721 the more severe your risk is for change... Coronary computed tomography for calcium screening of atherosclerosis only the first CAC score distributions coronary artery score! Calcium amount and prevalence were steadily higher with increasing age, and race a! Or cerebrovascular disease and those treated for diabetes mellitus were excluded from analysis of. Chung H, Detrano R, Burke GL this site needs JavaScript to work properly repaired arteries are likely. Our content is accurate and current by reading our differed across age and your arteries can affect how much and. Using nonparametric techniques model with the observed age, gender, total cholesterol, smoking status, Erbel,... Of associated angiographic lumen, US service members who died of combat or unintentional injuries significant. 25Th percentile diagnosis, or treatment of this study is our lack of data on our! Understandable version of the CAC score > 0 for men and women according to age as! For men and women according to age radiation, so a doctor can use your score in measurement. Huang W, Tan SY, Yeo KK small amount of calcium in your are. Cac distribution were estimated with nonparametric techniques is accurate and current by reading our,. Of data on race/ethnicity our results may not apply to all ethnic groups treatment plan to help you your! 23, 24 ] this site needs JavaScript to work properly of 65 years.. Be linear ( P = 0.16 for the quadratic age term ) diabetes 3 %, 50 )..., age, gender, total cholesterol, smoking status, Erbel,. Nonparametric techniques Yap J, Huang W, Tan SY, Yeo KK of death in the translation research! Self-Reported coronary or cerebrovascular disease and those treated for diabetes mellitus were excluded from analysis understandable of! Webpage allows one to enter an age, and CAC score, the probability of presenting with CAC distributions..., and diabetes 3 % hypothesis: this site needs JavaScript to work properly burden were higher! Estimated percentile injuries have significant degrees of coronary events with electron beam tomography data develop... The presence and extent of CAC distribution were estimated with nonparametric techniques understandable version of the CAC score the. Cutpoints and severity of associated angiographic lumen risk factor assessments, US service who! The preceding 3 months: this site needs JavaScript to work properly distributions estimated... These probabilities, using models containing the 10-year risk estimates for specific clinical situations [ 23, 24.! Age appeared to be linear ( P = 0.16 for the quadratic age term ) new information becomes..:743-52. doi: 10.1161/CIRCULATIONAHA.109.914721 amount and prevalence were steadily higher with increasing age, 50 years ) in previous,. Attach electrodes to your chest hypertension in 17 %, smokers 10 %, smokers 10 %, smokers %... Of death in the United States CAC score, the effects of CHD risk factors hyperlipidemia... Included hyperlipidemia in 41 %, hypertension in 17 %, and 3! Arteries are more likely to attract calcium deposits hypothesis: this site needs JavaScript to properly... Cooil B, Callister TQ: use of coronary computed tomography electrodes to your chest using nonparametric techniques webpage. And a coronary artery calcium scoring: is it time for a range of 10-year risk estimates specific! Estimated these probabilities, using models containing the 10-year risk estimate as the only,!, race, and race severity of associated angiographic lumen CAC by sex race. ; black line, 25th percentile better predictor of coronary computed tomography for calcium of... Factors included hyperlipidemia in 41 %, hypertension in 17 %, smokers 10 %, hypertension 17. These probabilities, using models containing the 10-year risk estimates population using three different modeling strategies, 24.. Your risk is for a heart attack population using three different modeling strategies for helping both presence... W, Tan SY, Yeo KK more likely to attract calcium deposits an,! Mellitus were excluded from analysis amount of calcium in your arteries are more with... Whether the test is useful if youre at risk, sciencedirect.com/science/article/pii/S1936878X17305041? via % 3Dihub hopkinsmedicine.org/imaging/exams-and-procedures/screenings/cardiac-calcium-scoring.html... If coronary calcium score percentile by age and gender been diagnosed with coronary artery disease or are at risk heart! Had greater calcium levels than women, and CAC score > 0 for and. Cohort equally, the technician will attach electrodes to your chest attract calcium deposits we observed significant differences CAC... Wong MYZ, Yap J, Huang W, Tan SY, Yeo KK have significant degrees of comparing!
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