The prevalence and distribution of coronary artery calcium in asymptomatic Korean population

Coronary artery calcium score (CACS) is a strong predictor of coronary heart disease and provides incremental prognostic information beyond traditional risk factors. The difference in prevalence and distribution of CACS in different ethnic groups has been reported with conflicting results. We aimed to investigate the prevalence and distribution of CACS in asymptomatic Korean population. A total of 5,239 asymptomatic patients free of known coronary artery disease who had coronary artery calcium scoring computed tomography during comprehensive medical examinations were included in the analysis. Coronary calcium was present in 33.1% of overall population, 40.5% of males and 19.3% of females. In all age groups, CACS was higher in males. The pattern of increase in CACS appeared in different patterns, with earlier and gradual increase in males. In females, there was a time-lag, behind that observed in males by about 10 years. Multivariate analysis showed that male gender (OR 3.759, 95% CI 3.120–4.529, P < 0.001), older age (OR 1.095, 95% CI 1.085–1.106, P < 0.001), pulse pressure (OR 1.142, 95% CI 1.063–1.227, P < 0.001), HbA1C (OR 1.390, 95% CI 1.255–1.540, P < 0.001), and obesity defined by body mass index (BMI) ≥ 25 kg/m² (OR 1.042, 95% CI 1.011–1.073, P = 0.007) were related to the presence of coronary artery calcification (CACS > 0). This study provides a healthy reference value of coronary artery calcification in Korean subjects, based on sex and age percentiles. Similar age and gender associations and distributions of coronary artery calcification are found, compared to the previous studies in western populations, but median CACS tend to be lower in Koreans.