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.
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Korea Statistics (KOSTAT) (2014) The statistics of death cause in 2013. http://kostat.go.kr
Heo SY, Park N-H, Park C-S et al (2016) Relationship between Framingham risk score and coronary artery calcium score in asymptomatic Korean individuals. J Korean Soc Radiol 74(2):75–81
Sung J, Cho SJ, Choe YH et al (2015) Relationship between aerobic fitness and progression of coronary atherosclerosis. Heart Vessels. doi:10.1007/s00380-015-0745-2
Shin W, Choe YH, Kim SM et al (2014) Detection of cardiac myxomas with non-contrast chest CT. Acta Radiol 55(3):273–278
Min JH, Kim SM, Lee S et al (2014) Diagnostic performance of algorithm for computer-assisted detection of significant coronary artery disease in patients with acute chest pain: comparison with invasive coronary angiography. Am J Roentgenol 202(4):730–737
Kim SM, Chang SA, Shin W et al (2014) Dual-energy CT perfusion during pharmacologic stress for the assessment of myocardial perfusion defects using a second-generation dual-source CT: a comparison with cardiac magnetic resonance imaging. J Comput Assist Tomogr 38(1):44–52
Chang SA, Kim SM, Choi SH et al (2014) Clinical utility of coronary CT angiography with stress perfusion CT in preoperative cardiac risk evaluation. Korean Circ J 44(3):170–176
Yoon YE, Lim TH (2014) Current roles and future applications of cardiac CT: risk stratification of coronary artery disease. Korean J Radiol 15(1):4–11
Park HE, Kim MK, Choi SY et al (2012) The prevalence and distribution of coronary artery calcium in asymptomatic Korean population. Int J Cardiovasc Imaging 28(5):1227–1235
Nam JG, Choi SH, Kang BS et al (2015) Development of coronary vasospasm during adenosine-stress myocardial perfusion CT imaging. Korean J Radiol 16(3):673–677
Lee S, Choi EK, Chang HJ et al (2010) Subclinical coronary artery disease as detected by coronary computed tomography angiography in an asymptomatic population. Korean Circ J 40(9):434–441
Kim YJ, Yong HS, Kim SM et al (2015) Korean guidelines for the appropriate use of cardiac CT. Korean J Radiol 16(2):251–285
Greenland P, Bonow RO, Brundage BH et al (2007) ACCF/AHA 2007 clinical expert consensus document on coronary artery calcium scoring by computed tomography in global cardiovascular risk assessment and in evaluation of patients with chest pain: a report of the American College of Cardiology Foundation Clinical Expert Consensus Task Force (ACCF/AHA Writing Committee to Update the 2000 Expert Consensus Document on Electron Beam Computed Tomography). Circulation 115(3):402–426
Detrano R, Guerci AD, Carr JJ et al (2008) Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med 358(13):1336–1345
Janowitz WR, Agatston AS, Kaplan G et al (1993) Differences in prevalence and extent of coronary artery calcium detected by ultrafast computed tomography in asymptomatic men and women. Am J Cardiol 72(3):247–254
McClelland RL, Chung H, Detrano R et al (2006) Distribution of coronary artery calcium by race, gender, and age: results from the Multi-Ethnic Study of Atherosclerosis (MESA). Circulation 113(1):30–37
Hoff JA, Daviglus ML, Chomka EV et al (2003) Conventional coronary artery disease risk factors and coronary artery calcium detected by electron beam tomography in 30,908 healthy individuals. Ann Epidemiol 13(3):163–169
Pletcher MJ, Tice JA, Pignone M et al (2004) What does my patient’s coronary artery calcium score mean? Combining information from the coronary artery calcium score with information from conventional risk factors to estimate coronary heart disease risk. BMC Med 2:31
Pletcher MJ, Sibley CT, Pignone M et al (2013) Interpretation of the coronary artery calcium score in combination with conventional cardiovascular risk factors: the Multi-Ethnic Study of Atherosclerosis (MESA). Circulation 128(10):1076–1084
Rumberger JA, Brundage BH, Rader DJ et al (1999) Electron beam computed tomographic coronary calcium scanning: a review and guidelines for use in asymptomatic persons. Mayo Clin Proc 74(3):243–252
Wong ND, Budoff MJ, Pio J et al (2002) Coronary calcium and cardiovascular event risk: evaluation by age- and sex-specific quartiles. Am Heart J 143(3):456–459
Hoff JA, Chomka EV, Krainik AJ et al (2001) Age and gender distributions of coronary artery calcium detected by electron beam tomography in 35,246 adults. Am J Cardiol 87(12):1335–1339
Chen CK, Kuo YS, Liu CA et al (2012) Frequency and risk factors associated with atherosclerotic plaques in patients with a zero coronary artery calcium score. J Chin Med Assoc 75(1):10–15
Won KB, Chang HJ, Niinuma H et al (2014) Differential association between obesity and coronary artery disease according to the presence of diabetes in a Korean population. Diabetol Metab Syndr 6(1):134
Kodama T, Kondo T, Oida A et al (2012) Computed tomographic angiography-verified plaque characteristics and slow-flow phenomenon during percutaneous coronary intervention. J Am Coll Cardiol Cardiovasc Interv 5(6):636–643
Fujiyoshi A, Sekikawa A, Shin C et al (2013) A cross-sectional association of obesity with coronary calcium among Japanese, Koreans, Japanese Americans, and U.S. whites. Eur Heart J Cardiovasc Imaging 14(9):921–927
Lamprea-Montealegre JA, McClelland RL, Astor BC et al (2013) Chronic kidney disease, plasma lipoproteins, and coronary artery calcium incidence: the Multi-Ethnic Study of Atherosclerosis. Arterioscler Thromb Vasc Biol 33(3):652–658
Yeboah J, Delaney JA, Nance R et al (2014) Mediation of cardiovascular risk factor effects through subclinical vascular disease: the Multi-Ethnic Study of Atherosclerosis. Arterioscler Thromb Vasc Biol 34(8):1778–1783
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Jang, S.Y., Kim, S.M., Sung, J. et al. Coronary artery calcium scores and cardiovascular risk factors in 31,545 asymptomatic Korean adults. Int J Cardiovasc Imaging 32 (Suppl 1), 139–145 (2016). https://doi.org/10.1007/s10554-016-0892-2
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DOI: https://doi.org/10.1007/s10554-016-0892-2