title: Prevalence and severity of coronary artery calcification based on the epidemiologic pattern: A propensity matched comparison of asymptomatic Korean and Chinese adults.
abstract: BACKGROUND
  Lifestyle, environmental, and genetic factors substantially influence cardiovascular disease (CVD) risk. We aimed to explore epidemiologic trends in coronary artery calcium scores (CACS), as a marker of CVD, along with possible differences by geographic area and study period in separate East Asian populations.
  
  
  METHODS
  We generated 3 matched groups (n=702) using a propensity scoring approach derived from a Korean (N=48,901) and Chinese cohort (N=927) as follows: (1) A recent Chinese group and (2) recent Korean group, both of whom underwent CACS scanning from 2012-2014; and (3) a past Korean group who underwent CACS scanning 8-10years before the index group (2002-2006). We used logistic regression to generate odds ratios (OR) with 95% confidence intervals (95% CI) to estimate the likelihood of having CACS between the groups, based on CACS stratified by severity: >0 (any), >100 (moderate), and >400 (severe).
  
  
  RESULTS
  The prevalence of any, moderate, or severe CACS did not differ significantly between the recent Chinese and Korean groups. Notably, the odds of the presence of moderate CACS in the recent Chinese group (OR: 3.05, 95% CI: 1.49-6.71, P-value<0.001) and the presence of any CACS in the recent Korean group (OR: 1.58, 95% CI: 1.17-2.15, P-value<0.001) were significantly higher than in the past Korean group.
  
  
  CONCLUSIONS
  In this study involving separate East Asian populations, there were no geographic differences in the prevalence of CACS. However, changes in other unmeasured factors over time are likely the culprits for the elevated prevalence of CACS in asymptomatic East Asians.
authors.affiliation: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Republic of Korea; Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medical College, New York, NY, USA.
authors.forename: Donghee
authors.initials: D
authors.lastname: Han
authors.affiliation: Department of Radiologic Imaging, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center of Cardiovascular Diseases, Beijing, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medical College, New York, NY, USA.
authors.forename: Bríain
authors.initials: B
authors.lastname: Ó Hartaigh
authors.affiliation: Department of Imaging, Cedars Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Heidi
authors.initials: H
authors.lastname: Gransar
authors.affiliation: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Republic of Korea; Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medical College, New York, NY, USA.
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medical College, New York, NY, USA.
authors.forename: Asim
authors.initials: A
authors.lastname: Rizvi
authors.affiliation: Division of Cardiology, Seoul National University Healthcare System Gangnam Center, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Su-Yeon
authors.initials: SY
authors.lastname: Choi
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seoul, Republic of Korea.
authors.forename: Eun Ju
authors.initials: EJ
authors.lastname: Chun
authors.affiliation: Division of Cardiology, Department of Medicine, Sungkyunkwan University School of Medicine, Heart Stroke & Vascular Institute, Samsung Medical Center, Seoul, Republic of Korea.
authors.forename: Jidong
authors.initials: J
authors.lastname: Sung
authors.affiliation: Department of Internal Medicine, Gangnam Heartscan Clinic, Seoul, Republic of Korea.
authors.forename: Hae-Won
authors.initials: HW
authors.lastname: Han
authors.affiliation: Department of Radiology, Gangnam Heartscan Clinic, Seoul, Republic of Korea.
authors.forename: Sung Hak
authors.initials: SH
authors.lastname: Park
authors.affiliation: Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medical College, New York, NY, USA.
authors.forename: James K
authors.initials: JK
authors.lastname: Min
authors.affiliation: Department of Radiologic Imaging, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center of Cardiovascular Diseases, Beijing, China. Electronic address: blu@vip.sina.com.
authors.forename: Bin
authors.initials: B
authors.lastname: Lu
authors.affiliation: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Republic of Korea. Electronic address: hjchang@yuhs.ac.
authors.forename: Hyuk-Jae
authors.initials: HJ
authors.lastname: Chang
mesh_terms: D002681:China / Q000453:epidemiology; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000453:epidemiology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D057216:Propensity Score; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D061205:Vascular Calcification / Q000175:diagnosis / Q000453:epidemiology*
keywords: Coronary artery calcium score; Coronary artery disease; East Asian; Epidemiology; Risk factors