| Part I Distribution characteristics of coronary artery calcium in community population of BeijingPurpose To initially evaluate the distribution characteristics of coronary artery calcium (CAC) and coronary artery calcium score (CACS) in the community population of Beijing with 64-MDCT, providing the baseline data for CAC evolution and risk stratification of coronary heart disease prevention study in China.Materials and methods Participants random sampling from the community population of Shougang, Shijingshan, and Xishan in Beijing were enrolled in the study according to inclusion criteria and exclusion criteria. All subjects underwent coronary calcium scan with 64-MDCT (GE, LightSpeed VCT) in Fuwai Hospital from September,2007 to January,2010. CAC score (Agatston score) of each subject was calculated respectively. The characteristics and difference of CAC and CACS was compared between groups of gender and age.Results 1) The study population consisted of 2,507 participants (mean age 53.68+8.68,47.4% males), of which 843 (33.6%) individuals had a positive CAC resul-t. The CAC positive rate in male was 41.3% (491/1188), significantly higher than the rate of 26.7%(352/1319) in female (p<0.001).2) CACS presented a positively-skewed distribution in the total population, in each gender and each age group of the same gender. In each gender, positive rate of CAC and CACS increased significantly with age respectively(p<0.01). the CAC positive rate and CACS of male is higher than of female in the same age groups except age groups of≤40y and>70y.3) 363 (14.5%) had a single-vessel lesion,480 (19.2%) had a multiple-vessel lesion in the total population, which had no difference between gender.4) The CAC positive rate of LAD (747,29.8%) and RCA (407,16.2%) was higher than of other coronary arteries in the population(p <0.001). The CAC positive rate of the four coronary arteries (LM, LAD, LCX, RCA) was higher in male than in female respectively (p<0.001). Conclusions There were significantly differences of CAC an CACS distribution between gender and age group in the population of Beijing communities.64-MDCT can detect and quantify CAC easily and quickly, evaluate the CAC distribution and coronary atherosclerosis characteristics in community population.Part II Association between coronary artery calcium and conventional risk factors of coronary heart disease in community population of BeijingPurpose To evaluate the association between coronary artery calcium (CAC) and the conventional risk factors of coronary heart disease in the community population of Beijing.Materials and methods Participants random sampling from the community population of Shougang, Shijingshan, and Xishan in Beijing were enrolled in the study according to inclusion criteria and exclusion criteria. All subjects underwent coronary calcium scan with 64-MDCT in Fuwai Hospital from May,2008 to January,2010. CAC score (Agatston score) of each subject was calculated respectively. Standard questionare of conventional cardiovascular disease risk factors, anthropometric data, electrocardiogram, blood pressure and biochemical examination of each subject was also obtained. Multivariable Logistc and linear regressions were used to determine the cross-sectional association of risk factors with positive coronary artery calcium (CAC, defined as "+"/"-") and coronary artery calcium score[(CACS, transformed into natural logarithm (In) (CACS+1)] in each gender and after gender adjustment.Results The study population consisted of 1,863 participants aged from 35-77 years (mean age 54.09±8.61,887 males). The CAC positive rate and CACS were significantly higher in male than in female (43.2% vs.29.0%,111.91±318.46 vs.58.09±222.69, respectively, p<0.001). The independent risk factors of CAC (+/-) and CACS in male were age, hypertension, diabetes mellitus and family history of CHD (p<0.05). The independent risk factors of CAC (+/-) and CACS in female were age, hypertension and family history of CHD (p<0.05). After gender adjustment, the independent risk factors of CAC (+/-) were age, hypertension, hyperlipidemia, diabetes mellitus and family history of CHD (p <0.05), and of CACS were age, hypertension, diabetes mellitus and family history of CHD (p<0.05).Conclusions The CAC and CACS in the population of Beijing communities detected by 64-MDCT is associated with conventional cardiovascular disease risk factors. The presence and extent of coronary artery atherosclerosis in the population can be predicted by conventional risk factors. Of all the factors, hypertension and diabetes mellitus is the best two predictors for the presence of coronary artery atherosclerosis, and age is the best predictor for the extent of coronary artery atherosclerosis.PartⅢAssociation between coronary artery calcium and carotid intima-media thickness in Xishan community population of BeijingPurpose To evaluate the association between coronary artery (CAC) calcium and carotid intima-media thickness(IMT) in Xishan community population of Beijing.Materials and methods Participants random sampling from the community population of Xishan in Beijing were enrolled in the study. Subjects underwent B-mode ultrasonography to measure the IMT of common carotid artery (CCA) and internal carotid artery (ICA), and underwent coronary calcium scan with 64-MDCT to calculate CAC score (Agatston score) respectively. The distribution characteristics and differences of CCA-IMT and ICA-IMT was compared between groups of age, gender, and CAC. The correlation of CCA-IMT and CACS,ICA-IMT and CACS were assessed.Results The study population consisted of 982 participants aged from 35～75 years (mean age 54.26±9.92,475 males). CCA-IMT and ICA-IMT of male were significantly thicker than of female (0.86±0.19 vs.0.80±0.17, p<0.001; 0.65±0.15 vs.0.60±0.14,p< 0.001; respectively). The CAC positive rate and CACS of male were significantly higher than of female respectively (p <0.001). There was no difference of CACS between genders (p=0.29). CCA-IMT and ICA-IMT increased with age in each gender (p<0.001). CCA-IMT and ICA-IMT of positive CAC group were thicker than of negative CAC group in each gender (p<0.001). Except ICA-IMT in CACS groups of 101～400 in both genders and CCA-IMT of 401～1000 in female, CCA-IMT and ICA-IMT increased with CACS in each gender (p<0.001). Spearman correlation analysis showed that there were slightly correlation between CACS and CCA-IMT, ICA-IMT in male (r=0.35 and 0.30, respectively) and in female (r=0.41 and 0.26, respectively). (p< 0.001).Conclusions CCA-IMT and ICA-IMT were significantly different between genders, age groups, and CAC groups in Xishan community population of Beijing. There were slightly correlations between CCA-IMT, ICA-IMT and CACS.
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