Coronary artery calcium scores and cardiovascular risk factors in 31,545 asymptomatic Korean adults

Abstract

The aims of this study were to identify the distribution of coronary artery calcium score (CACS) by age group and cardiovascular (CV) risk factors and to evaluate the association between CV risk factors and CACS classification in asymptomatic adults. The study included 31,545 asymptomatic Koreans, over 20 years of age with no previous history of malignancy, proven coronary artery disease, or stroke, who underwent CACS computed tomography at the Health Promotion Center, Samsung Medical Center, between January 2005 and June 2013. Mean (±SD) age was 53.8 (±8.5) years overall, 56.1 (±8.3) in men, and 53.3 (±8.5) in women. They were classified into five groups based on their resting CACS: none (CAC = 0), minimal (0 < CAC ≤ 10), mild (10 < CAC ≤ 100), moderate (100 < CAC ≤ 400), and extensive (400 > CAC). Older age groups exhibited higher CACS values. The proportion of CACS classification in our study was 55.5 % with no CACS, 9.5 % with minimal CACS, 19.8 % with mild CACS, 10.8 % with moderate CACS, and 4.3 % with extensive CACS. Adjusted odds ratios (ORs) were calculated for CV risk factors to determine their association with CACS. When analyzed according to sex, in males, the adjusted OR for CACS increased with the presence of hypertension (HT), diabetes mellitus (DM), obesity, chronic kidney disease, and smoking status. While, in females, the adjusted OR for CACS increased with the presence of HT, DM, and obesity. CV risk factors appear to be significantly associated with CACS in the Korean population.

The impact of visceral fat and levels of vitamin D on coronary artery calcification

“…Results of univariate and multivariate analyses showed an increased prevalence of CCA among hypertensive individuals, consistent with the results of previous studies 13,14 . Although the inter-relationship between hypertension, coronary atherosclerosis, and calcification is not fully understood, some mechanisms, such as the induction of trauma to the arterial wall, have been proposed.…”

A pooled-analysis of age and sex based coronary artery calcium scores percentiles

“…Among these, 12 studies fulfilled the inclusion criteria and contained all information necessary to create the new CAC score nomogram and were therefore included in this analysis. 10,[14][15][16][17][18][19][20][21][22][23][24] The reasons for exclusion of potentially eligible studies are provided in Supplemental Fig. 1.…”

“…A total of 134,336 asymptomatic patients from the western hemisphere were included, 10,14-22 of which 34% were women and 19% were under the age of 45 years. In the analyses of Asians, a total of 33,488 asymptomatic individuals were included, 13,14,23,24 of which 18% were women and 12% were under the age of 45 years.…”

The ratio of the max-to-mean coronary artery calcium score in the most calcified vessel is associated with the presence of coronary artery disease

“…Hence, Agatston score max:mean should be carefully regarded when assessing the risk of CAD by the CACS based on coronary CTA. Age, diabetes, and hypertension were also found to be positively associated with increased Agatston score max:mean , similar to the risk factors for the total Agatston score [20]. Nevertheless, there was no significant association between blood lipids and CACS max:mean or the presence of CAD, which might be attributed to higher use of lipidlowering drugs among patients with CAD.…”