Age and gender distributions of coronary artery calcium detected by electron beam tomography in 35,246 adults

doi:10.1016/S0002-9149(01)01548-X

The American Journal of Cardiology

Volume 87, Issue 12, 15 June 2001, Pages 1335-1339

https://doi.org/10.1016/S0002-9149(01)01548-X Get rights and content

Abstract

Electron beam tomography (EBT) is a noninvasive method used to detect coronary artery calcium (CAC). Due to the age-associated increase in incidence and magnitude of CAC, interpretation of results can be difficult. The purpose of this study was to develop a set of age- and gender-stratified CAC distributions to serve as standards for the clinical interpretation of EBT scans. Between 1993 and 1999, 35,246 asymptomatic subjects, 30 to 90 years of age, were self-referred for CAC screening using an Imatron EBT scanner. CAC score was calculated based on the number, areas, and peak computed tomographic density for each detected calcific lesion. 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. Total CAC scores were assigned to a percentile according to age and gender. CAC scores were reported at the 10th, 25th, 50th, 75th, and 90th percentiles for 16 age and/or gender groups. The prevalence of CAC increased with age for men and women. The extent of CAC differed significantly between men and women in the same age group. In summary, this study reports the distribution of CAC score by age and gender. Knowledge of the distribution of CAC, the effect of age on the total CAC score as well as the differences in total CAC scores that exist between men and women of similar age will assist the clinician in interpreting EBT CAC results.

Section snippets

Study subjects

Between January 1993 and September 1999, 41,021 subjects, ages 30 to 90 years, underwent EBT CAC screening. Subjects who reported (≥1 of the following conditions) medical history of angina, coronary angiography, catheter-based intervention, coronary artery bypass surgery, and/or myocardial infarction were not included in this analysis (n = 5,775). Thus, the study sample consisted of 25,251 men and 9,995 women who were free of known CAD at the time of CAC screening.

CAC screening was performed at

Sample characteristics

The study sample consisted primarily of white (80%) men and women who were 30 to 90 years of age. All subjects were self-referred for the CAC screening procedure. Demographic characteristics are summarized in Table 1. Education and income levels in our population were higher compared with national averages reported for the United States population.20

CAD risk factors, including age, smoking, CAD in other family members, history of hypercholesterolemia, diabetes mellitus, systemic hypertension,

Discussion

A major impediment to the use of EBT screening is the unavailability of a set of population-based standards against which scans can be compared.17 The use of large databases of patients screened by EBT allows for the construction of tables of age–sex percentiles. The percentiles reported rank subjects against matched populations, suggesting an “anatomic age” for their coronary arteries. An age–sex nomogram would be useful in classifying subjects based on the extent of their atherosclerotic

Acknowledgements

We are indebted to Bruce Friedman, MBA, Daniel B. Garside, MS, Vladimir Jelnin, MD, Alex Sevrukov, MD, and Shu-Pi Chen, PhD, for their assistance in the preparation of this manuscript.

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^☆: This study was supported with internal funding from the Department of Medicine, Section of Cardiology, University of Illinois, Chicago, Illinois.

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Age and gender distributions of coronary artery calcium detected by electron beam tomography in 35,246 adults☆

Abstract

Section snippets

Study subjects

Sample characteristics

Discussion

Acknowledgements

Mayo Clin Proc

Radiol Clin North Am

Am J Cardiol

J Am Coll Cardiol

Am J Cardiol

J Am Coll Cardiol

Am J Cardiol

J Am Coll Cardiol

Am J Cardiol

J Clin Epidemiol

Am J Cardiol

J Am Coll Cardiol

Lancet

ACC/AHA Expert consensus document on electron-beam computed tomography for the diagnosis and prognosis of coronary artery disease

Circulation