Coronary Artery Calcification in the Asian Population: An Overview of the Results from the Korea Initiatives on Coronary Artery Calcification Registry

Coronary artery calcium score (CACS), determined using computed tomography, is a robust marker of calcific atherosclerosis and is associated with atherosclerotic plaque burden. Although CACS is a well-established tool for early coronary artery disease (CAD) detection, prior studies have revealed some differences in the prevalence and severity of CAC according to ethnicity or race, which underscores the need to re-appraise the clinical utility of CACS in the Asian population. Korea Initiatives on Coronary Artery Calcification (KOICA) was designed to identify the effectiveness of CACS for primary prevention of CAD in asymptomatic Korean adults. This registry comprises 86,165 adults who underwent CAC scanning at one of five centers in Korea between 2002 and 2014. Based on its multisite approach and large sample size, KOICA has and will continue to provide answers to important questions regarding the effect of CACS on CAD. This article discusses the rationale of CACS use in the Asian population and describes key findings from KOICA.