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CT May Better Predict Patients at Higher Risk for Heart Disease

By MedImaging staff writers
Posted on 17 Jun 2008

Adding noninvasive imaging to current risk-assessment protocols may identify more people who are at risk of developing heart disease.

Researchers used data from the University of Texas (UT) Southwestern Medical Center (Dallas, USA)-led Dallas Heart Study to determine whether using computed tomography (CT) to scan patients' hearts for calcium deposits and blockages could identify more individuals at high risk for heart disease and who could benefit from cholesterol-lowering therapy.

The recommendations by the Screening for Heart Attack Prevention and Education (SHAPE) task force were a proposed update to the current guidelines, and were updated by the U.S. National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) in 2004. In findings published in the May 28, 2008, issue of the journal Archives of Internal Medicine, researchers found that the additional imaging proposed by the SHAPE task force did indeed increase the number of patients classified at high risk.

"We added imaging of coronary artery calcium, as recommended by the SHAPE task force, to determine if this strategy would augment current risk assessment,” said Dr. Jason Lindsey, an author of the study and cardiology fellow at UT Southwestern.
The efficiency of calcium screening according to the SHAPE recommendations was determined by the number of people who had to be scanned before a single participant was reclassified as either meeting or not meeting individual cholesterol goals.

"In our sample of participants in the Dallas Heart Study, we found that by applying SHAPE recommendations compared with the current guidelines [NCEP-ATP III], there was a 27% relative increase in the proportion of patients who would need lipid-lowering therapy,” said Dr. James de Lemos, associate professor of internal medicine at UT Southwestern and the study's senior author.

SHAPE calls for a wider application of atherosclerosis imaging than is currently recommended. Whether increased imaging of patients will be cost effective in the long term remains to be seen, according to Dr. de Lemos. "We can't say what would happen in terms of clinical outcomes, but in terms of risk assessment we can provide a model of how these guidelines would impact treatment,” Dr. de Lemos said. "We found that for every seven people who had calcium imaging, one needed to readjust cholesterol goals to lower levels.”

Coronary calcium scans utilize computerized tomography (CT) to scan the heart and look for calcium deposits and blockages. The risk of coronary heart disease increases with higher calcium scores. Calcium buildup can lead to atherosclerosis, a metabolic and inflammatory disease that causes plaque to accumulate in the arteries.

Dr. Scott Grundy, director of the Center for Human Nutrition at UT Southwestern and an author on the Archives article, served as chairman of the NCEP panel that updated the guidelines for the clinical use of cholesterol-lowering medications to reduce the risk of cardiovascular disease.

Current NCEP guidelines identify three categories of risk based on an individual's likelihood to develop cardiovascular disease (heart attack and stroke) in the near future: high risk, moderately high risk, and lower to moderate risk. High-risk individuals are those who have already had a heart attack; cardiac chest pain (angina); previous angioplasty or bypass surgery; obstructed blood vessels to the arms, legs, or brain; diabetes; or a collection of other risk factors that raise the likelihood of having a heart attack in the next 10 years by more than 20%.

The proportion of participants identified as not meeting their cholesterol goals increased with age, with the greatest net increase among people ages 55 to 65 years old.

The study was conducted as part of the Dallas Heart Study; a multiethnic, population-based study of more than 6,000 patients in Dallas County designed to examine cardiovascular disease. The multiyear study aims to gather information to help improve the diagnosis, prevention, and treatment of heart disease.

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University of Texas Southwestern Medical Center

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62 (654.93583679199): SELECT fid FROM jos_deeppockets WHERE id=286070000 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=286070000 AND published='1' LIMIT 1

63 (458.0020904541): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=211 ORDER BY `ordering`

64 (81.062316894531): select jos_twitters.link from jos_twitters where cat=10

65 (44.107437133789): select jos_facebook.link from jos_facebook where cat=10

66 (36.954879760742): select jos_google_plus.link from jos_google_plus where cat=10

67 (34.093856811523): select jos_linkedin.link from jos_linkedin where cat=10

68 (57.93571472168): SELECT fid FROM jos_deeppockets WHERE id=286070000 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=286070000 AND published='1' LIMIT 1

69 (36.954879760742): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=211 ORDER BY `ordering`

70 (413.89465332031): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=286070000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (380.9928894043): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=286070000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (64.849853515625): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (88.930130004883): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (47.206878662109): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (47.922134399414): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (47.922134399414): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (51.021575927734): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (39.815902709961): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (53.167343139648): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (81.062316894531): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=286070000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (32.901763916016): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=286070000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (67.949295043945): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (82.969665527344): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (53.882598876953): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (38.862228393555): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (43.869018554688): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (39.815902709961): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (108.00361633301): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286070000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286070000 AND published='1' LIMIT 1

105 (81.062316894531): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286070000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286070000 AND published='1' LIMIT 1

106 (96.08268737793): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=286070000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (84.877014160156): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=286070000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (83.92333984375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286070000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286070000 AND published='1' LIMIT 1

109 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286070000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286070000 AND published='1' LIMIT 1

110 (72.002410888672): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=286070000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (776.05247497559): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=286070000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (898.12278747559): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (511.16943359375): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (228.8818359375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286070000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286070000 AND published='1' LIMIT 1

115 (247.95532226562): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286070000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286070000 AND published='1' LIMIT 1

116 (69.856643676758): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286070000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286070000 AND published='1' LIMIT 1

117 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286070000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286070000 AND published='1' LIMIT 1

118 (!!!!! 2846.0025787354): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286070000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286070000 AND published='1' LIMIT 1

119 (!!!!! 1116.9910430908): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286070000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286070000 AND published='1' LIMIT 1

120 (72.002410888672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286070000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286070000 AND published='1' LIMIT 1

121 (63.896179199219): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286070000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286070000 AND published='1' LIMIT 1

122 (500.91743469238): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 73179.960250854): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

124 (761.03210449219): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=286070000 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=286070000 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 21681.070327759): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (110.14938354492): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (87.976455688477): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

128 (52.928924560547): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

129 (83.92333984375): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

130 (55.074691772461): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

131 (456.09474182129): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

132 (59.843063354492): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (51.975250244141): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

134 (44.107437133789): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

135 (!!!!! 1833.9157104492): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286070000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (544.07119750977): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286070000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (336.88545227051): SELECT name FROM jos_deeppockets WHERE id=211

138 (56.982040405273): SELECT name FROM jos_deeppockets WHERE id=211

139 (753.87954711914): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (614.88151550293): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (!!!!! 5465.030670166): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286070000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286070000 AND published='1' LIMIT 1

142 (84.877014160156): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286070000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286070000 AND published='1' LIMIT 1

143 (!!!!! 19551.992416382): TRUNCATE TABLE jos_trademed_module

144 (!!!!! 4526.8535614014): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=286070000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (949.85961914062): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=286070000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (591.99333190918): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286070000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (84.877014160156): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286070000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (108.00361633301): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286070000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286070000 AND published='1' LIMIT 1

149 (69.856643676758): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286070000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286070000 AND published='1' LIMIT 1

150 (!!!!! 1537.0845794678): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

151 (85.830688476562): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286070000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286070000 AND published='1' LIMIT 1

152 (69.141387939453): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286070000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286070000 AND published='1' LIMIT 1

153 (42.915344238281): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=286070000 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=286070000 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (38.862228393555): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

155 (44.822692871094): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

156 (61.03515625): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (99.18212890625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286070000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286070000 AND published='1' LIMIT 1

158 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286070000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286070000 AND published='1' LIMIT 1

159 (68.187713623047): select jos_twitters.link from jos_twitters where cat=10

160 (32.186508178711): select jos_facebook.link from jos_facebook where cat=10

161 (36.954879760742): select jos_google_plus.link from jos_google_plus where cat=10

162 (38.862228393555): select jos_linkedin.link from jos_linkedin where cat=10

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