DISTRIBUTION OF CORONARY ARTERY CALCIUM SCORE BASED ON AGE AND GENDER IN HEALTHY POPULATION
Introduction: Coronary Artery Calcification (CAC) score may give information in cardiovascular risk stratification asymptomatic individuals. Profiles and distribution of CAC scores are still scarce in Indonesia. This study aimed to evaluate the distribution of CAC based on age and gender in asymptomatic patients.
Methods: Subjects were asymptomatic Asian above 40 years-old undergoing cardiovascular check-up, including Computed Tomography (CT) CAC at Siloam Heart Institute, from April 2018 to August 2019. Data were obtained retrospectively and analyzed statistically with IBM SPSS version 22.
Results: A total of 1640 patients were enrolled, with males slightly more than half. The mean age was 55,6 ± 9,6 years, with age group of 50-59 years as the majority (35,9%). Almost half of the subjects had zero CAC score. Around two-thirds of females, particularly below 50 years old, had zero CAC scores. CAC scores >400 were more prevalent in males across all age groups. The majority of healthy males had a CAC score between 0-99. There was a positive correlation between age and CAC scores in both genders. Females with CAC score >400 were found mostly after 70 years old, ten years older than males. CAC score >1000 was more prevalent in older males compared to females.
Conclusion: The distribution of CAC score is remarkably affected by age and gender. Zero CAC score is found predominant in our subjects. CAC scores of ≥400 are common in males across all age groups. CAC score >1000 is more exclusively found in the elderly male
Yusuf S, Reddy S, Ôunpuu S, Anand S. Clinical Cardiology : New Frontiers Global Burden of Cardiovascular Diseases. Circulation. 2001;104(C):2746–53.
Han D, ó Hartaigh B, Gransar H, Lee JH, Choi SY, Chun EJ, et al. Prevalence and distribution of coronary artery calcification in asymptomatic United States and Korean adults – Cross-sectional propensity-matched analysis. Circ J. 2016;80(11):2349–55.
Fujiyoshi A, Miura K, Ohkubo T, Kadowaki T, Kadowaki S, Zaid M, et al. Cross-sectional comparison of coronary artery calcium scores between Caucasian men in the United States and Japanese Men in Japan: The multi-ethnic study of atherosclerosis and the Shiga epidemiological study of subclinical atherosclerosis. Am J Epidemiol. 2014;180(6):590–8.
Meadows TA, Bhatt DL, Cannon CP, Gersh BJ, Röther J, Goto S, et al. Ethnic differences in cardiovascular risks and mortality in atherothrombotic disease: Insights from the reduction of atherothrombosis for continued health (REACH) registry. Mayo Clin Proc. 2011;86(10):960–7.
Tillin T, Hughes AD, Mayet J, Whincup P, Sattar N, Forouhi NG, et al. The relationship between metabolic risk factors and incident cardiovascular disease in Europeans, South Asians, and African Caribbeans: SABRE (Southall and Brent Revisited) - A prospective population-based study. J Am Coll Cardiol [Internet]. 2013;61(17):1777–86. Available from: http://dx.doi.org/10.1016/j.jacc.2012.12.046
Detrano R, Guerci AD, Carr JJ, Bild DE, Burke G, Folsom AR, et al. Coronary Calcium as a Predictor of Coronary Events in Four Racial or Ethnic Groups. N Engl J Med. 2008;358(13):1336–45.
Sangiorgi G, Rumberger JA, Severson A, Edwards WD, Gregoire J, Fitzpatrick LA, et al. Arterial calcification and not lumen stenosis is highly correlated with atherosclerotic plaque burden in humans: A histologic study of 723 coronary artery segments using nondecalcifying methodology. J Am Coll Cardiol. 1998;31(1):126–33.
Pereira AC, Gomez LM, Bittencourt MS, Staniak HL, Sharovsky R, Foppa M, et al. Age, Gender, and Race-Based Coronary Artery Calcium Score Percentiles in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Clin Cardiol. 2016;39(6):352–9.
Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M, Detrano R. Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol. 1990;15(4):827–32.
Callister TQ, Cooil B, Raya SP, Lippolis NJ, Russo DJ, Raggi P. Coronary artery disease: Improved reproducibility of calcium scoring with an electron-beam CT volumetric method. Radiology. 1998;208(3):807–14.
Hoffmann U, Siebert U, Bull-Stewart A, Achenbach S, Ferencik M, Moselewski F, et al. Evidence for lower variability of coronary artery calcium mineral mass measurements by multi-detector computed tomography in a community-based cohort - Consequences for progression studies. Eur J Radiol. 2006;57(3):396–402.
Bodenheimer MM. Long-term prognostic value of coronary calcification detected by electron beam computed tomography in patients undergoing coronary arteriography. Circulation. 2002;105(17).
Parikh P, Shah N, Ahmed H, Schoenhagen P, Fares M. Coronary artery calcium scoring: Its practicality and clinical utility in primary care. Cleve Clin J Med. 2018;85(9):707–16.
Neves PO, Andrade J, Monção H. Coronary artery calcium score: current status. Radiol Bras. 2017;50(3):182–9.
Asafu Adjaye Frimpong G, Owusu IK, Anyitey-Kokor IC, Wiafe-Kwakye CSNS, Aboagye E, Coleman NE, et al. Age–gender distribution of coronary artery calcium score in a black African population in Ghana. Vasc Health Risk Manag. 2018;14:75–80.
Budoff MJ, Nasir K, Mao S, Tseng PH, Chau A, Liu ST, et al. Ethnic differences of the presence and severity of coronary atherosclerosis. Atherosclerosis. 2006;187(2):343–50.
McClelland RL, Chung H, Detrano R, Post W, Kronmal RA. Distribution of coronary artery calcium by race, gender, and age: Results from the Multi-Ethnic Study of Atherosclerosis (MESA). Circulation. 2006;113(1):30–7.
Makaryus AN, Sison C, Kohansieh M, Makaryus JN. Implications of gender difference in coronary calcification as assessed by ct coronary angiography. Clin Med Insights Cardiol. 2015;8(Suppl. 4):51–5.
Ohmoto-Sekine Y, Yanagibori R, Amakawa K, Ishihara M, Tsuji H, Ogawa K, et al. Prevalence and distribution of coronary calcium in asymptomatic Japanese subjects in lung cancer screening computed tomography. J Cardiol [Internet]. 2016;67(5):449–54. Available from: http://dx.doi.org/10.1016/j.jjcc.2015.06.010
Sekikawa A, Curb JD, Ueshima H, El-Saed A, Kadowaki T, Abbott RD, et al. Marine-Derived n-3 Fatty Acids and Atherosclerosis in Japanese, Japanese-American, and White Men. A Cross-Sectional Study. J Am Coll Cardiol. 2008;52(6):417–24.
Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ, et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Vol. 140, Circulation. 2019. 596–646 p.
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.