Men exhibited a higher coronary artery calcium burden than women, with scores increasing exponentially with age; the 75th percentile CAC scores rose from 2 at 45-54 years to 441 at ≥75 years in men versus 0 to 137 in women, indicating lower calcification burden in the Japanese population compared to Western cohorts.
Observational (n=4,891)
No
What are the age- and sex-specific reference values for coronary artery calcium in a healthy Japanese population?
This study provides the first large-scale, age- and sex-specific CAC reference values for a healthy Japanese population, demonstrating a significantly lower CAC burden compared to Western cohorts and highlighting the need for population-specific thresholds.
Background The clinical use of coronary artery calcium (CAC) scoring for risk stratification in Japan is limited by the absence of population‐specific reference data, as applying Western‐derived thresholds is inappropriate because of known ethnic variations. This study aimed to establish the first comprehensive, age‐ and sex‐specific CAC reference values for a healthy Japanese population. Methods In this single‐center retrospective study, we analyzed data from 4891 asymptomatic Japanese adults (63.2% men; median age, 58 years) without a history of atherosclerotic cardiovascular disease or diabetes. Age‐ and sex‐specific CAC percentile curves were generated using nonparametric regression modeling. Results Men exhibited a higher CAC burden than women, with scores increasing with age in both sexes. The relationship between detectable CAC (CAC >0) and age was nonlinear: concave down for men and concave up for women, indicating different progression patterns. Compared with MESA (Multi‐Ethnic Study of Atherosclerosis) data, the Japanese cohort had a markedly lower CAC burden than White participants and systematically lower scores than Chinese American women. Conclusions This study provides the first large‐scale, age‐ and sex‐specific CAC reference values for a healthy Japanese population. The generated percentile curves offer a practical tool for clinicians to immediately assess a patient’s CAC burden relative to their peers, underscoring that using foreign‐derived thresholds is inappropriate for risk stratification in Japan.
Takagi et al. (2026) conducted an observational in Asymptomatic Japanese adults without a history of atherosclerotic cardiovascular disease or diabetes (n=4,891). Coronary artery calcium scoring was evaluated on Age- and sex-specific coronary artery calcium (CAC) score distribution in an asymptomatic Japanese population. Men exhibited a higher coronary artery calcium burden than women, with scores increasing exponentially with age; the 75th percentile CAC scores rose from 2 at 45-54 years to 441 at ≥75 years in men versus 0 to 137 in women, indicating lower calcification burden in the Japanese population compared to Western cohorts.