CARDIOVASCULAR RADIOLOGY / ORIGINAL PAPER
Distribution, extent, and calculated age of initiation of coronary artery calcification
1
3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
2
Department of Medical Informatics and Artificial Intelligence, Silesian University of Technology, Zabrze, Poland
3
Department of Biostatistics, Faculty of Public Health in Bytom, Medical University of Silesia, Katowice, Poland
4
2nd Department of Cardiology and Angiology, Silesian Center for Heart Diseases, Zabrze, Poland
5
Department of Vascular, General and Transplantation Surgery, Wroclaw Medical University, Wroclaw, Poland
Submission date: 2025-05-28
Final revision date: 2025-09-03
Acceptance date: 2025-09-09
Publication date: 2026-01-08
Corresponding author
Monika Zofia Czaja-Ziółkowska
2nd Department of Cardiology and Angiology, Silesian Center for Heart Diseases, 9 Marii Curie-Skłodowskiej St., 41-800 Zabrze, Poland
2nd Department of Cardiology and Angiology, Silesian Center for Heart Diseases, 9 Marii Curie-Skłodowskiej St., 41-800 Zabrze, Poland
Pol J Radiol, 2026; 91(1): 11-19
KEYWORDS
computed tomographycoronary atherosclerosisleft anterior descending coronary arteryvascular ageplaque distribution
TOPICS
ABSTRACT
Purpose:
The aim of this study was to characterize the distribution of coronary plaque burden and gender differences in the estimated age of coronary artery calcium (CAC) initiation in patients with moderate or low probability of coronary artery disease using cardiac computed tomography imaging.
Material and methods:
CAC was measured using the Agatston method. The patients were categorized into risk categories based on CAC score (CACs) and based on the number of involved coronary vessels. We investigated CAC distribution and plaque burden throughout the coronary vasculature in both sexes. Furthermore, we calculated the calcification initiation in each main coronary artery territory, assuming that average annual CACs progression is 25% per year.
Results:
Among the 937 affected vessels, calcifications were most prevalent in the left anterior descending artery (LAD), with a higher plaque burden ratio. Among patients with a low CAC burden, the LAD was the most frequently involved vessel. Analysis of the estimated age of CAC initiation reveals that calcification begins to develop earlier in the LAD than in other coronary territories in both sexes. Involvement of the second coronary artery territory after one-vessel disease can be expected after a median of 4.5 years (range 2.2-8), with no significant difference between men and women.
Conclusions:
Calcified plaque was most commonly identified in the LAD. CAC occurs earlier in the LAD than in other coronary arteries. The particular susceptibility to calcification of LAD is not related to gender.
The aim of this study was to characterize the distribution of coronary plaque burden and gender differences in the estimated age of coronary artery calcium (CAC) initiation in patients with moderate or low probability of coronary artery disease using cardiac computed tomography imaging.
Material and methods:
CAC was measured using the Agatston method. The patients were categorized into risk categories based on CAC score (CACs) and based on the number of involved coronary vessels. We investigated CAC distribution and plaque burden throughout the coronary vasculature in both sexes. Furthermore, we calculated the calcification initiation in each main coronary artery territory, assuming that average annual CACs progression is 25% per year.
Results:
Among the 937 affected vessels, calcifications were most prevalent in the left anterior descending artery (LAD), with a higher plaque burden ratio. Among patients with a low CAC burden, the LAD was the most frequently involved vessel. Analysis of the estimated age of CAC initiation reveals that calcification begins to develop earlier in the LAD than in other coronary territories in both sexes. Involvement of the second coronary artery territory after one-vessel disease can be expected after a median of 4.5 years (range 2.2-8), with no significant difference between men and women.
Conclusions:
Calcified plaque was most commonly identified in the LAD. CAC occurs earlier in the LAD than in other coronary arteries. The particular susceptibility to calcification of LAD is not related to gender.
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