Abstract
Abstract Background Coronary artery calcium (CAC) scoring is a promising tool for cardiovascular risk classification. Population-based reference values are important for the clinical interpretation of CAC scores. Purpose To establish standards of CAC distributions by age and gender in an unselected Dutch population, which can be used to determine reference values. Methods ImaLife (Imaging in Lifelines) is a computed tomography (CT) based substudy of the Lifelines cohort, with a primary aim to establish reference values of imaging biomarkers for early stages of coronary artery disease in adults (above 45 years old). In total, 12,000 participants will be enrolled from an unselected adult population in the northern Netherlands for CAC scoring with third generation dual-source CT. CAC is quantified with dedicated commercial software using the Agatston method. Results Included so far were 3,702 participants (57.5% females, mean age 54 years, range 45–82 years). CAC was present in 39.2% of participants, with a higher prevalence of CAC in men (55.3%) than in women (27.3%). CAC scores increased with increasing age in both genders. The percentiles of CAC scores by age and gender groups are summarized in the table. Agatston CAC score percentiles by age and gender Percentiles Women – Age, years Men – Age, years 45–49 50–54 55–59 60–64 65∼ 45–49 50–54 55–59 60–64 65∼ N 505 634 719 260 10 355 473 543 185 18 25th 0 0 0 0 0 0 0 0 1 75 50th 0 0 0 0 4 0 1 6 22 556 75th 0 0 6 33 386 6 21 72 129 751 90th 4 26 77 120 1037 49 154 242 500 1803 Conclusion This preliminary result presents CAC distribution by age and gender in a middle-aged unselected Dutch population. Compared with the Heinz Nixdorf Recall study, CAC scores in our cohort for both genders were lower in the 5-year age groups between 45 and 64 years. Based on the overall data, expected within 2 years, reference values of CAC for the Dutch population can be established.
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