Prevalence of coronary atherosclerosis in an Asian population: findings from coronary computed tomographic angiography

We sought to estimate the prevalence of coronary atherosclerosis by coronary computed tomographic angiography (CCTA) and to identify risk factors attributable to the development of coronary atherosclerosis in an asymptomatic Asian population. We analyzed 6,311 consecutive asymptomatic individuals aged 40 and older with no prior history of coronary artery disease (CAD) who voluntarily underwent CCTA evaluation as part of a general health examination. The mean age of study participants was 54.7 ± 7.4 years, and 4,594 (72.8 %) were male. After age and gender adjustment using the population census of the National Statistical Office, the prevalence of plaque was 40.5 % [95 % confidence interval (CI) 38.1–42.9], and significant CAD (diameter stenosis ≥50 %) was observed in 9.0 % (95 % CI 7.7–10.2). Individuals with significant CAD were significantly older than those without (59.2 ± 8.8 vs. 54.0 ± 7.1 years, p < 0.001). Compared with individuals with no cardiovascular risk factors, there was a higher prevalence of significant CAD in individuals with diabetes mellitus [standardized rate ratio (SRR) 2.66; 95 % CI 1.93–3.68; p < 0.001], hypertension (SRR 2.24; 95 % CI 1.69–2.97; p < 0.001), or hyperlipidemia (SRR 1.65; 95 % CI 1.25–2.17; p < 0.001). There was also a greater prevalence of significant CAD in individuals with an intermediate or high Framingham risk score (SRR 5.91; 95 % CI 2.34–14.95; p < 0.001) or a high atherosclerotic cardiovascular disease risk score (SRR 8.04; 95 % CI 3.04–21.23; p < 0.001). The prevalence of coronary atherosclerosis in this Asian population was not negligible and was associated with known cardiovascular risk factors and high-risk individuals.