Deciphering age- and sex-specific patterns of coronary artery atherosclerosis from a large Chinese cohort
Coronary artery disease poses a significant public health threat, and coronary computed tomography angiography is the preferred imaging modality for diagnosis and risk assessment of coronary artery disease through plaque evaluation. However, understandings of how atherosclerotic characteristics vary by age and sex remains limited due to challenges in manual quantitative plaque assessment. Here, we conducted a retrospective, consecutive, multi-center Chinese cohort study of 16,300 patients undergoing clinically indicated coronary computed tomography angiography that revealed multi-level quantitative patterns of atherosclerosis stratified by age and sex. We found that females experienced a delayed atherosclerosis onset by approximately 20 years compared to males, with plaque burden increasing nonlinearly with age and accelerating more evidently after menopause. The built coronary atlas identified plaque clusters, primarily within proximal segments of major coronary arteries, slightly upstream side branch bifurcations. Our findings provide deeper insights into coronary atherosclerosis in the Chinese population, supporting more tailored prevention strategies.
Authors
- Dinggang G. Shen (ORCID: https://orcid.org/0000-0002-7934-5698)
- Yining Dong (ORCID: https://orcid.org/0000-0002-4617-6947)
- Jiayin Zhang (ORCID: https://orcid.org/0000-0001-7383-7571)
- Xinnian Yang (ORCID: https://orcid.org/0000-0001-7970-1536)
- Yiqiang Zhan (ORCID: https://orcid.org/0000-0001-8391-2555)
- Dengqiang Jia
- Dijia Wu (ORCID: https://orcid.org/0000-0002-0636-9912)
- Qingqi Hong (ORCID: https://orcid.org/0000-0002-9996-6870)
- Xiang Sean Zhou (ORCID: https://orcid.org/0000-0002-4907-249X)
- Yanli Song
- Yining Wang (ORCID: https://orcid.org/0009-0006-5141-5048)
Institutions
- City University of Hong Kong (HK)
- Shanghai Jiao Tong University (CN)
- Xiamen University (CN)
- Chinese Academy of Medical Sciences & Peking Union Medical College (CN)
- Peking Union Medical College Hospital (CN)
- ShanghaiTech University (CN)
- United Imaging Healthcare (China) (CN)
- Shanghai First People's Hospital (CN)
- Shanghai Clinical Research Center (CN)
- Macao Polytechnic University (MO)
Publication Details
- Journal
- Nature Communications
- Published
- 2025-11-22
- DOI
- https://doi.org/10.1038/s41467-025-64940-8
- Citations
- 1
- Primary Topic
- Cardiac Imaging and Diagnostics
- Type
- article
- Field-Weighted Citation Impact
- 1.36
Funders
- City University of Hong Kong
- National Natural Science Foundation of China
- Shanghai Municipal Education Commission
- ShanghaiTech University
- National Key Research and Development Program of China