Distribution of coronary artery calcium volume and density by age, sex, and race using AI-based quantification...

Area of Science:

• Cardiovascular Imaging
• Biomedical Engineering
• Radiology

Background:

• The Agatston score is a standard measure for coronary artery calcium (CAC) quantification.
• Recent research indicates that CAC volume and mean density possess independent prognostic value.
• Normative distributions for CAC volume and mean density across diverse demographic groups remain underexplored.

Purpose of the Study:

• To establish percentile distributions for coronary artery calcium (CAC) volume and average mean density.
• To characterize these distributions across various age, sex, and race strata.
• To provide data for improved contextualization of CAC interpretation and cardiovascular risk stratification.

Main Methods:

• Analysis of 23,844 asymptomatic patients without prior atherosclerotic cardiovascular disease who underwent cardiac CT.
• Quantification of CAC volume and mean density using deep learning-based software.
• Stratification by sex, race (White, Black), and age (10-year strata) with LOESS-based percentile construction and Mann-Whitney U testing.

Main Results:

• Men exhibited higher CAC volume than women across all strata (59 mm³ vs 28 mm³).
• White patients generally had higher average mean CAC density than Black patients (194 HU vs 171 HU).
• Age-related increases in both CAC volume and density were observed across all demographic groups.

Conclusions:

• This study presents normative percentile distributions for CAC volume and average mean density.
• These distributions are stratified by age, sex, and race.
• The findings offer valuable data for enhanced CAC interpretation and cardiovascular risk assessment.