In a recent study by Blaha et al.(JACC Cardiovascular Imaging, 2016) based on the MESA trial, the authors have shown that the coronary artery calcium (CAC) score can be improved by addition of regional measure of calcium distribution. The aim of this study was to evaluate the CAC score and calcium distribution of the Dutch ROBINSCA trial and to compare this with the multi-ethnic MESA trial.

Participants of the ROBINSCA trial who had a CAC CT scan from January 2015 through May 2017 were included. All participants gave their written informed consent. The percentage of positive CAC score, Agatston score per vessel and calcium distribution were determined. The number of vessels containing CAC was registered and diffusivity index was calculated for the whole population and per given number of vessels affected. Participants with a positive score were categorized in groups based on Agatston score: 1-100, 101-300, >300, and patterns of calcium...

Of the 7,516 ROBINSCA participants, 4,494 (59.8%) had a positive Agatston score (59.4% male, mean age 62.9 (SD:7.1)). The mean Agatston score was 209.4 (SD:424.0) and median was 56.2 (IQR:11.7-203.9). Of the participants with a positive score, in 35.6%, 26.8%, 24.6%, 13.0% respectively 1, 2, 3 and 4 vessels were affected (Fig. 1). The mean age, diffusivity index and median calcium score increased for increasing number of vessels that were affected (p<0.001). A higher percentage of ROBINSCA participants had a positive score compared to MESA...

In the ROBINSCA population, a higher number of participants had a positive CAC score compared to the MESA population. Of those participants, a similar amount of vessels were involved but with a more concentrated CAC pattern.

M. Blaha et al. Improving the CAC Score by Addition of Regional Measures of Calcium Distribution, JACC: Cardiovascular Imaging, Vol 9 No 12, 2016